Provider Demographics
NPI:1194712950
Name:MOHAMMADI, SAEID (MD)
Entity type:Individual
Prefix:
First Name:SAEID
Middle Name:
Last Name:MOHAMMADI
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 1:9026 N 83RD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1817
Mailing Address - Country:US
Mailing Address - Phone:480-323-0838
Mailing Address - Fax:480-588-6212
Practice Address - Street 1:2039 S MILL AVE
Practice Address - Street 2:SUITE E
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2137
Practice Address - Country:US
Practice Address - Phone:480-968-2990
Practice Address - Fax:480-968-6498
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32760208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ905557OtherAHCCCS
AZ905557OtherAHCCCS