Healthcare Provider Details

I. General information

NPI: 1043270879
Provider Name (Legal Business Name): AFFILIATED ARM, SHOULDER & HAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3104 E INDIAN SCHOOL RD SUITE #200
PHOENIX AZ
85016-6889
US

IV. Provider business mailing address

3104 E INDIAN SCHOOL RD SUITE #200
PHOENIX AZ
85016-6889
US

V. Phone/Fax

Practice location:
  • Phone: 602-954-9484
  • Fax: 602-954-6433
Mailing address:
  • Phone: 602-954-9484
  • Fax: 602-954-6433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number12438
License Number StateAZ

VIII. Authorized Official

Name: DR. SEBASTIAN B RUGGERI
Title or Position: OWNER
Credential: M.D.
Phone: 602-954-9484