Organization Name: | WISSAM FAYAD M.D. PC |
NPI Number: | 1003129719 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WISSAM A FAYAD (OWNER) |
Mailing Address: | 1841 W 25th St Suite A Yuma |
State: | AZ US |
Postal Code: | 853646920 |
Phone Number: | 9283445565 |
Fax Number: | 9283445655 |
NPI Enumeration Date: | 07/22/2010 |
NPI Last Update Date: | 04/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 35717 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |