Provider Demographics
NPI:1396052254
Name:JAMIL, SADAF (DO)
Entity type:Individual
Prefix:
First Name:SADAF
Middle Name:
Last Name:JAMIL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 W ANTHEM WAY
Mailing Address - Street 2:SUITE A-109 PMB 313
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-0430
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3655 W ANTHEM WAY
Practice Address - Street 2:SUITE A-109 PMB 313
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-0430
Practice Address - Country:US
Practice Address - Phone:623-505-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005687208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine