Individual
SHADI MAHER KOLEILAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2450 E RIVER RD, TUCSON, AZ 85718-6526
(520) 795-7750
Mailing address
2450 E RIVER RD, TUCSON, AZ 85718-6526
(520) 795-7750
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
54482
AZ
2084N0400X
Neurology Physician
R74122
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
389563
—
AZ
Enumeration date
06/20/2013
Last updated
11/19/2020
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