Healthcare Provider Details
I. General information
NPI: 1750550265
Provider Name (Legal Business Name): ARROWHEAD FAMILY CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/28/2008
Last Update Date: 09/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6320 W UNION HILLS DR STE A210
GLENDALE AZ
85308-7212
US
IV. Provider business mailing address
6320 W UNION HILLS DR STE A210
GLENDALE AZ
85308-7212
US
V. Phone/Fax
- Phone: 623-362-8866
- Fax: 623-362-8867
- Phone: 623-362-8866
- Fax: 623-362-8867
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
NED
D
STOLZBERG
Title or Position: PHYSICIAN/OWNER/PRESIDENT
Credential: M.D.
Phone: 623-362-8866