Healthcare Provider Details

I. General information

NPI: 1619970050
Provider Name (Legal Business Name): STEVEN G. WHITTLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W THOMAS RD ATTN: SURGICAL SUITE
PHOENIX AZ
85013
US

IV. Provider business mailing address

350 W THOMAS RD ATTN: SURGICAL SUITE
PHOENIX AZ
85013
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3541
  • Fax: 602-406-7135
Mailing address:
  • Phone: 602-406-3541
  • Fax: 602-406-7135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2000-125
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number69007
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: