Healthcare Provider Details

I. General information

NPI: 1285601682
Provider Name (Legal Business Name): JULIA ANN PIWOZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E THOMAS RD
PHOENIX AZ
85016-7710
US

IV. Provider business mailing address

PO BOX 8022
CHANDLER AZ
85246-8022
US

V. Phone/Fax

Practice location:
  • Phone: 480-636-1149
  • Fax: 480-452-0998
Mailing address:
  • Phone: 480-636-1149
  • Fax: 480-452-0998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number190235
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number25MA06584700
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number61511
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: