Healthcare Provider Details

I. General information

NPI: 1568675908
Provider Name (Legal Business Name): TWIN PEDIATRICS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 N 2ND ST STE 201
PHOENIX AZ
85020-2446
US

IV. Provider business mailing address

9100 N 2ND ST STE 201
PHOENIX AZ
85020-2446
US

V. Phone/Fax

Practice location:
  • Phone: 602-395-1388
  • Fax: 602-395-1378
Mailing address:
  • Phone: 602-395-1388
  • Fax: 602-395-1378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number21732
License Number StateAZ

VIII. Authorized Official

Name: DR. LUDWIG D DUMAPLIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 602-395-1388