Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 01068703A | IN |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 01068703A | IN |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 51687 | AZ |
NPI | 1205097110 |
---|---|
Provider Name | Hicham El Masry |
First Address | Mesa, AZ 85206-4394 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 08/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000694490 | ANTHEM BCBS (01) | IN |
106658 | (05) | AZ |
201007910 | (05) | IN |
P00945280 | RAILROAD MEDICARE (SVMG) (01) | IN |