Individual
TARIQ SUBHI AL-MUTAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1510 E FLOWER ST, PHOENIX, AZ 85014-5698
(602) 530-6900
Mailing address
1510 E FLOWER ST, PHOENIX, AZ 85014-5698
(602) 530-6900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30032
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690778
—
AZ
Enumeration date
08/02/2005
Last updated
02/27/2014
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