Provider Demographics
NPI:1699118240
Name:HASOON, MOHAMMED TAHIR (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:TAHIR
Last Name:HASOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMED
Other - Middle Name:TAHER
Other - Last Name:AL-MARZOOQ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3805 E BELL RD STE 3100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2136
Mailing Address - Country:US
Mailing Address - Phone:602-867-8644
Mailing Address - Fax:602-606-5128
Practice Address - Street 1:9100 N 2ND ST STE 3100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2446
Practice Address - Country:US
Practice Address - Phone:602-867-8644
Practice Address - Fax:602-606-5128
Is Sole Proprietor?:No
Enumeration Date:2013-04-14
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ61149207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology