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Individual

DR. NIZAMID-DIN B MISSAGHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5110 N 44TH ST, SUITE L200, PHOENIX, AZ 85018-1649
(602) 343-2900

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35246
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
152822
AZ
01
P00625152
RAILROAD MEDICARE
AZ
Enumeration date
07/13/2006
Last updated
08/20/2012
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