Healthcare Provider Details

I. General information

NPI: 1427248806
Provider Name (Legal Business Name): ROBERT ANTHONY CHAVEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 N CENTRAL AVE SUITE 1600
PHOENIX AZ
85004-4527
US

IV. Provider business mailing address

1850 N CENTRAL AVE SUITE 1600
PHOENIX AZ
85004-4527
US

V. Phone/Fax

Practice location:
  • Phone: 602-262-8900
  • Fax: 602-262-4134
Mailing address:
  • Phone: 602-262-8900
  • Fax: 602-262-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number36896
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: