Healthcare Provider Details

I. General information

NPI: 1629653456
Provider Name (Legal Business Name): HANDS-ON MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 E MARYLAND AVE
PHOENIX AZ
85012-1126
US

IV. Provider business mailing address

126 E MARYLAND AVE
PHOENIX AZ
85012-1126
US

V. Phone/Fax

Practice location:
  • Phone: 216-551-5388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NACHMAN ULLMAN
Title or Position: PRESIDENT
Credential: DO
Phone: 216-551-5388