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NPI Code Detail

MEDICARE: JOHN W DESALVO MD

MEDICARE:   JOHN W DESALVO  MD
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
1207V00000XObstetrics & Gynecology Physician21631AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497745350
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN W DESALVO MD
Provider Business Mailing Address
First Line : 5601 W EUGIE AVE
Second Line : STE 100
City : GLENDALE
State : AZ
Zip : 85304-1255
Country : US
Telephone Number : 602-978-1500
Fax Number : 602-978-0409
Provider Business Practice Location Address
First Line : 5601 W EUGIE AVE
Second Line : STE 100
City : GLENDALE
State : AZ
Zip : 85304-1255
Country : US
Telephone Number : 602-978-1500
Fax Number : 602-978-0409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 07/09/2007

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Directions to “ JOHN W DESALVO MD” Practice Location

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