Provider Demographics
NPI:1154554236
Name:MOUNZER, RAWAD (MD)
Entity type:Individual
Prefix:
First Name:RAWAD
Middle Name:
Last Name:MOUNZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441N 12TH ST.
Mailing Address - Street 2:DIGESTIVE INSTITUTE
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006
Mailing Address - Country:US
Mailing Address - Phone:602-521-5180
Mailing Address - Fax:602-521-5180
Practice Address - Street 1:1441 N 12TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2837
Practice Address - Country:US
Practice Address - Phone:602-521-5180
Practice Address - Fax:602-521-5180
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443952207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology