Provider Demographics
NPI:1104520758
Name:ALAM, SYED MOZAMMIL (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:MOZAMMIL
Last Name:ALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOZAMMIL
Other - Middle Name:SYED
Other - Last Name:ALAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:755 E MCDOWELL RD FL 3
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2506
Mailing Address - Country:US
Mailing Address - Phone:602-521-3300
Mailing Address - Fax:
Practice Address - Street 1:755 E MCDOWELL RD FL 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2506
Practice Address - Country:US
Practice Address - Phone:602-521-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program