Provider Demographics
NPI:1427236629
Name:AL SOUQI, MOHAMMAD KHALID SADIQ (MBBS)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:KHALID SADIQ
Last Name:AL SOUQI
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 N 1ST AVE
Mailing Address - Street 2:APT # 1107
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1077
Mailing Address - Country:US
Mailing Address - Phone:520-891-6801
Mailing Address - Fax:
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:UNIVERSITY OF ARIZONA ,UMC ROOM 6336
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-5040
Practice Address - Country:US
Practice Address - Phone:520-626-2761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ79940390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program