Healthcare Provider Details

I. General information

NPI: 1255652426
Provider Name (Legal Business Name): JOHN DAVID NERVA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 W THUNDERBIRD RD STE 308
GLENDALE AZ
85306-4710
US

IV. Provider business mailing address

5310 W THUNDERBIRD RD STE 308
GLENDALE AZ
85306-4710
US

V. Phone/Fax

Practice location:
  • Phone: 602-462-0469
  • Fax: 602-865-4508
Mailing address:
  • Phone: 602-462-0469
  • Fax: 602-865-4508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number80599
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: