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Individual

HOUSAM ALASALY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4901 N 44TH ST STE 103, PHOENIX, AZ 85018-2782
(602) 954-0405
(602) 954-0485
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
27108
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
536724
AZ
01
Z291915
MEDICARE PTAN
AZ
Enumeration date
03/10/2006
Last updated
10/27/2023
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