| Desert Wounds, Pllc | |
|
1012 E Willetta St Phoenix AZ 85006-2749 | |
| (480) 907-7707 | |
| (480) 907-7097 |
| Full Name | Desert Wounds, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1012 E Willetta St, Phoenix, Arizona |
| Authorized Official Name and Position | Bashar S Majeed (SOLE MEMBER) |
| Authorized Official Contact | 6023189457 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Wounds, Pllc Po Box 11773 Chandler AZ 85248-0013 Ph: (480) 907-7707 | Desert Wounds, Pllc 1012 E Willetta St Phoenix AZ 85006-2749 Ph: (480) 907-7707 |
| NPI Number | 1700224482 |
|---|---|
| Provider Enumeration Date | 06/04/2013 |
| Last Update Date | 06/06/2013 |
| Medicare PECOS PAC ID | 2860634250 |
|---|---|
| Medicare Enrollment ID | O20130814000744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700224482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 36258 (Arizona) | Primary |
| Provider Name | Grigory Horonenko |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1356394035 PECOS PAC ID: 9638175219 Enrollment ID: I20061005000255 |
| Provider Name | Bashar Saad Matti Majeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952488694 PECOS PAC ID: 3971502808 Enrollment ID: I20061204000258 |
| Provider Name | Omid G Dilmaghanian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447376983 PECOS PAC ID: 7618053224 Enrollment ID: I20120120000184 |
| Provider Name | Suhair N Stipho-majeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265769749 PECOS PAC ID: 0547414260 Enrollment ID: I20130205000577 |
| Provider Name | William Nassour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104131820 PECOS PAC ID: 2264668615 Enrollment ID: I20131113002100 |
| Provider Name | Mohammad M Nasser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376835157 PECOS PAC ID: 4880996321 Enrollment ID: I20151230001268 |
| Provider Name | Yvette M Frey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770052086 PECOS PAC ID: 9830439124 Enrollment ID: I20190325000339 |
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