Individual
MR. KHOSROW MEHDI NAFISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1728 W GLENDALE AVE, STE 301, PHOENIX, AZ 85021
(602) 864-6828
(602) 864-6859
Mailing address
1728 W GLENDALE AVE, STE 301, PHOENIX, AZ 85021
(602) 864-6828
(602) 864-6859
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17558
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17558
—
AZ
01
—
AZ0325810
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
07/19/2006
Last updated
08/08/2011
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