Healthcare Provider Details

I. General information

NPI: 1487048583
Provider Name (Legal Business Name): ADAM SCOTT NORBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N 32ND ST STE 140
PHOENIX AZ
85018-3964
US

IV. Provider business mailing address

5310 HARVEST HILL RD STE 290
DALLAS TX
75230-5826
US

V. Phone/Fax

Practice location:
  • Phone: 602-494-1817
  • Fax: 602-494-7103
Mailing address:
  • Phone: 602-494-1817
  • Fax: 602-494-7103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number57854
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: