Healthcare Provider Details

I. General information

NPI: 1306601604
Provider Name (Legal Business Name): ARIZONA MATERNITY AND WOMEN'S CLINIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 N 91ST AVE STE B105
PHOENIX AZ
85037-4053
US

IV. Provider business mailing address

14961 W BELL RD STE 175
SURPRISE AZ
85374-3220
US

V. Phone/Fax

Practice location:
  • Phone: 623-243-7779
  • Fax: 623-243-6733
Mailing address:
  • Phone: 623-547-7205
  • Fax: 623-243-6733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDRES JULIAN ARANDA
Title or Position: CREDENTIALING
Credential:
Phone: 623-440-3136