Provider Demographics
NPI:1124599816
Name:MARICOPA PHYSICIANS PLLC
Entity type:Organization
Organization Name:MARICOPA PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALRABADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-729-4870
Mailing Address - Street 1:PO BOX 39292
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85069-9292
Mailing Address - Country:US
Mailing Address - Phone:480-729-4870
Mailing Address - Fax:
Practice Address - Street 1:6250 N 19TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1565
Practice Address - Country:US
Practice Address - Phone:480-729-4870
Practice Address - Fax:480-821-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ49923OtherSTATE LICENSE