MEDICARE: STEVEN CARY SIMON 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
1	208600000X	Surgery Physician	30664	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110570	OTHER	AZ	MEDICARE GROUP ID
3	Z110571	OTHER	AZ	MEDICARE PROVIDER ID

Other Identifiers

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

General Provider Information

NPI Number	:	1982604708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN CARY SIMON MD

Provider Business Mailing Address
First Line	:	202950 N. TATUM BLVD.
Second Line	:	SUITE 308
City	:	PHOENIX
State	:	AZ
Zip	:	85050-4255
Country	:	US
Telephone Number	:	480-419-2280
Fax Number	:	480-419-2290

Provider Business Practice Location Address
First Line	:	20950 N TATUM BLVD
Second Line	:	SUITE 308
City	:	PHOENIX
State	:	AZ
Zip	:	85050-4200
Country	:	US
Telephone Number	:	480-419-2280
Fax Number	:	480-419-2290

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	09/07/2011

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Directions to “ STEVEN CARY SIMON MD” Practice Location

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