Provider Demographics
NPI:1992953541
Name:AKL, AHMED NADER (MD)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:NADER
Last Name:AKL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29650
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038-9650
Mailing Address - Country:US
Mailing Address - Phone:480-656-0207
Mailing Address - Fax:480-939-3506
Practice Address - Street 1:10661 N FRANK LLOYD WRIGHT BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-2687
Practice Address - Country:US
Practice Address - Phone:480-656-0207
Practice Address - Fax:480-939-3506
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ45748207VF0040X
MI4301092312207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ736181Medicaid
AZ736181Medicaid