Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 39951 | IA |
N | 111NI0900X | Internist | 39951 | IA |
Y | 207RN0300X | Nephrologist | 56207 | AZ |
N | 207RN0300X | Nephrologist | 58950 | MN |
NPI | 1013146430 |
---|---|
Provider Name | Dr. Musab Sultan Hommos |
First Address | Scottsdale, AZ 85259-5499 |
Second Address | Scottsdale, AZ 85259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2009 |
Last Update Date | 09/09/2020 |