Healthcare Provider Details

I. General information

NPI: 1831279413
Provider Name (Legal Business Name): SETH ALAN STABINSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5651 N 7TH ST
PHOENIX AZ
85014-2500
US

IV. Provider business mailing address

5651 N 7TH ST
PHOENIX AZ
85014-2500
US

V. Phone/Fax

Practice location:
  • Phone: 602-263-4232
  • Fax: 602-604-6582
Mailing address:
  • Phone: 602-263-4232
  • Fax: 602-604-6582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number47399
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG75569
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: