Healthcare Provider Details

I. General information

NPI: 1548577422
Provider Name (Legal Business Name): WARIDIBO EVELYN ALLISON M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E ROOSEVELT ST
PHOENIX AZ
85008-4973
US

IV. Provider business mailing address

7160 E KIERLAND BLVD APT 514
SCOTTSDALE AZ
85254-2991
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-5011
  • Fax:
Mailing address:
  • Phone: 347-255-7853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number80121
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberQ8820
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number80121
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME128903
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: