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Contact Information

MOUSTAFA BANNA, MD
5859 W. TALAVI BLVD
SUITE 100
GLENDALE, AZ85306-1869
 Phone: 602-298-7777
 Fax: 623-930-6060
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MOUSTAFA BANNA · (Male)

NPI # 1003009861
Status Active
Credentials MD
Entity Individual
Enumeration date 08/23/2007
Last updated 11/16/2015 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 45263
  • PA License # MT186538
  • TX License # P6136
  • TX Medicaid 324413901
  • TX Medicaid 324413902
Hospital affiliation(s)
  • ARROWHEAD HOSPITAL - (Acute Care)
    18701 NORTH 67TH AVENUE
    GLENDALE, AZ 85308
  • BANNER THUNDERBIRD MEDICAL CENTER - (Acute Care)
    5555 WEST THUNDERBIRD ROAD
    GLENDALE, AZ 85306
  • WEST VALLEY HOSPITAL - (Acute Care)
    13677 WEST MCDOWELL ROAD
    GOODYEAR, AZ 85395
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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