Individual
NUSRUM IQBAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 COLONIA DE SALUD, SUITE 200C, SIERRA VISTA, AZ 85635-2487
(520) 335-2800
(520) 335-2804
Mailing address
75 COLONIA DE SALUD STE 200C, SIERRA VISTA, AZ 85635-2486
(520) 335-2800
(520) 335-2804
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32359
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
836033
—
AZ
01
—
DR2642
MEDICARE PTAN RR GROUP
AZ
01
—
P00915869
MEDICARE PTAN RR PROVIDER
AZ
01
—
Z140497
MEDICARE PTAN BUSINESS
AZ
01
—
Z140498
MEDICARE PTAN INDIVIDUAL
AZ
01
—
Z144296
MEDICARE PTAN FOR OROVALLEY, AZ
AZ
Enumeration date
07/07/2006
Last updated
08/10/2011
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