Healthcare Provider Details

I. General information

NPI: 1710086624
Provider Name (Legal Business Name): JOHN PETER SEWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10390 N LA CANADA DR STE 110
ORO VALLEY AZ
85737-7273
US

IV. Provider business mailing address

PO BOX 31235
TUCSON AZ
85751-1235
US

V. Phone/Fax

Practice location:
  • Phone: 520-420-2110
  • Fax: 520-420-2111
Mailing address:
  • Phone: 520-324-7802
  • Fax: 520-324-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number042722
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG28462
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42260
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: