MEDICARE: NEUROWEST IOM LLC

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	246ZE0500X	EEG Specialist/Technologist
2	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1083345722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROWEST IOM LLC

Provider Business Mailing Address
First Line	:	8149 E EVANS RD STE 10
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-3647
Country	:	US
Telephone Number	:	480-454-6311
Fax Number	:

Provider Business Practice Location Address
First Line	:	8149 E EVANS RD STE 10
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-3647
Country	:	US
Telephone Number	:	480-454-6311
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASHTON STEADMAN
Credential	:
Telephone Number	:	480-454-6311

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	06/22/2022

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Directions to “NEUROWEST IOM LLC ” Practice Location

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