Provider Demographics
NPI:1588717334
Name:ALMUTI, WALID JAMIL (MD)
Entity type:Individual
Prefix:DR
First Name:WALID
Middle Name:JAMIL
Last Name:ALMUTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12747 N 57TH DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1879
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19841 N 27TH AVE STE 403
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027
Practice Address - Country:US
Practice Address - Phone:602-439-0274
Practice Address - Fax:602-938-3189
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.096444207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH096444OtherSTATE LICENSE
AZ35819OtherMEDICAL LIC NUMBER