Provider Demographics
NPI:1336216803
Name:MIAN, AMMAR MAJEED (MD)
Entity type:Individual
Prefix:DR
First Name:AMMAR
Middle Name:MAJEED
Last Name:MIAN
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:PO BOX 25716
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-0111
Mailing Address - Country:US
Mailing Address - Phone:480-652-3487
Mailing Address - Fax:602-368-0446
Practice Address - Street 1:2423 W DUNLAP AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2830
Practice Address - Country:US
Practice Address - Phone:480-652-3487
Practice Address - Fax:602-368-0446
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36224207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ160171Medicaid
AZ070110Medicaid
AZ170110Medicaid
1063433720OtherCLINIC NPI
AZ170110Medicaid
1245344316OtherCLINIC NPI
AZZ160171Medicaid
AZZ112815Medicare PIN
031824Medicare Oscar/Certification
1962507376OtherCLINIC NPI
AZ170110Medicaid
031822Medicare Oscar/Certification
AZ031806Medicare Oscar/Certification
AZZ112814Medicare PIN
I67742Medicare UPIN
031823Medicare Oscar/Certification
AZZ160171Medicaid
AZZ112816Medicare PIN
AZZ181130Medicare PIN
AZZ21113Medicare PIN
AZZ21114Medicare PIN