Abdul Memon, MD, PLLC
Organization Active NPI Cardiovascular Disease Physician · Globe, AZ
NPI 1760622344 · NPPES record last updated Oct 31, 2018
Key facts
- NPI
- 1760622344
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 24282 (AZ)
- Legal business name
- ABDUL MEMON, MD, PLLC
- Practice address
- 5882 S Hospital Dr Ste 1
Globe, AZ 85501-9455 - Phone
- (928) 793-3747
- Fax
- (928) 793-3745
- NPI assigned
- Feb 23, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Abdul Q Memon, MD
- Title
- Owner
- Phone
- (928) 793-3747
Practitioners 19
-
Shiv Bagga, MD
-
Michelle Anne Craft, APRN-RNP, FNP-BC
-
Abdul Q Memon, MD
-
Fady Marmoush, MD
-
Murtaza Mazhar, M.D
-
Fahmeeda Awan, MBBS
-
Laurie Jenay Burnworth, PA-C
-
Natalija De Retana, AGNP
-
Ghassan Fraij, M.D.
-
Rebecca L McCollaum, A.P.R.N.
-
Ernesto R Cruz, MD
-
Himanshu Raj Ullal, PA-C
-
Divyashree Varma, M.D.
-
Stephen Michael Entrekin, P.A.
-
Frances Stier, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090501000109 | AZ | Part B Supplier - Clinic/Group Practice | 5294883211 |
Receives reassigned benefits from 16 practitioners Practice locations: Chandler, AZ; Globe, AZ |
National Provider Directory
Locations
2075 W Pecos Rd
Chandler, AZ 85224
Phone (480) 748-4238
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | 24282 | AZ | Yes |
Addresses
Primary practice location
5882 S Hospital Dr Ste 1
Globe, AZ 85501-9455
Mailing address
5882 S Hospital Dr Ste 1
Globe, AZ 85501-9455
Phone (928) 793-3747
Other practice location 1
2075 W Pecos Rd Ste 2
Chandler, AZ 85224-5723
Phone (480) 748-4238
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z128910 | Other | AZ | MEDICARE PTAN |
Other names
- Cardiovascular Associates of Arizona
Other providers in Globe, AZ
- Joseph G Abdo
- Ac Assisted Living
- Ac Assisted Living
- Ac Assisted Living
- Ac Assisted Living
- Ac Assisted Living 5 LLC
All providers in Globe, AZ · Cardiovascular Disease Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.