Healthcare Provider Details

I. General information

NPI: 1750398244
Provider Name (Legal Business Name): MATTHEW E WESTER AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 E MCDOWELL RD STE 200
PHOENIX AZ
85006-2608
US

IV. Provider business mailing address

1010 E MCDOWELL RD STE 206
PHOENIX AZ
85006-2608
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-0298
  • Fax: 602-254-8401
Mailing address:
  • Phone: 602-956-1250
  • Fax: 623-321-8620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberDA4871
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberDA4871
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: