MEDICARE: UNITED THERANOSTICS PHYSICIANS OF ARIZONA, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207U00000X	Nuclear Medicine Physician

General Provider Information

NPI Number	:	1003660051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED THERANOSTICS PHYSICIANS OF ARIZONA, PC

Provider Business Mailing Address
First Line	:	8300 NORMAN CENTER DR STE 160
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55437-1028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22455 N MILLER RD
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-4956
Country	:	US
Telephone Number	:	612-431-1898
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BABAK SABOURY
Credential	:
Telephone Number	:	612-431-1898

Provider Enumeration Date	:	04/16/2024
Last Update Date	:	04/16/2024

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