Provider Demographics
NPI:1992908404
Name:HADI INTERNAL MEDICINE ASSOCIATES LLC
Entity type:Organization
Organization Name:HADI INTERNAL MEDICINE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:VASIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-215-9892
Mailing Address - Street 1:PO BOX 12975
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-0050
Mailing Address - Country:US
Mailing Address - Phone:205-215-9892
Mailing Address - Fax:602-680-3974
Practice Address - Street 1:5656 S POWER RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-8487
Practice Address - Country:US
Practice Address - Phone:205-215-9892
Practice Address - Fax:602-680-3974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36063207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00448853OtherRAIL ROAD MEDICARE
AZDG6903OtherRAIL ROAD MEDICARE
AZZ116055Medicare PIN
AZZ116062Medicare PIN