Healthcare Provider Details

I. General information

NPI: 1649464827
Provider Name (Legal Business Name): DIGESTIVE HEALTH CENTER OF ARIZONA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 E CORONADO RD
PHOENIX AZ
85004-1525
US

IV. Provider business mailing address

349 E CORONADO RD
PHOENIX AZ
85004-1525
US

V. Phone/Fax

Practice location:
  • Phone: 602-266-5678
  • Fax: 602-264-5646
Mailing address:
  • Phone: 602-266-5678
  • Fax: 602-264-5646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID J DREWITZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 602-266-5678