Most Relevant Information
Provider Data
| NPI Number: | 1003009861 |
| Provider Name: | MOUSTAFA BANNA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207RC0000X |
| Specialty: | Internal Medicine |
| License Number: | 45263 |
Most Important Dates
| Enumeration Date: | 08/23/2007 |
| Last Updated: | 01/11/2024 |
Provider Practice Location
13460 N 94TH DR STE J1
PEORIA
AZ
853814246
Practice Location Phone/Fax
| Phone: | 6238768816 |
| Fax: | 6232980168 |
Provider Mailing Location
13460 N 94TH DR STE J1
PEORIA
AZ
853814246
Provider Mailing Phone/Fax
| Phone: | 6238768816 |
| Fax: | 6232980168 |
Suggested EMR
Internist EMR