Healthcare Provider Details

I. General information

NPI: 1558827998
Provider Name (Legal Business Name): STEWARD EMERGENCY PHYSICIANS OF ARIZONA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2019
Last Update Date: 02/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E VAN BUREN ST
PHOENIX AZ
85006-3742
US

IV. Provider business mailing address

1900 N PEARL ST STE 2400
DALLAS TX
75201-2470
US

V. Phone/Fax

Practice location:
  • Phone: 602-251-8100
  • Fax:
Mailing address:
  • Phone: 469-341-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SANJAY SHETTY
Title or Position: PRESIDENT
Credential: MD
Phone: 617-419-4700