Healthcare Provider Details

I. General information

NPI: 1881609667
Provider Name (Legal Business Name): PARADISE VALLEY OB/GYN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8404 E SHEA BLVD SUITE B 100
SCOTTSDALE AZ
85260-6658
US

IV. Provider business mailing address

8404 E SHEA BLVD SUITE B 100
SCOTTSDALE AZ
85260-6658
US

V. Phone/Fax

Practice location:
  • Phone: 480-443-4437
  • Fax: 480-443-4525
Mailing address:
  • Phone: 480-443-4437
  • Fax: 480-443-4525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number13732
License Number StateAZ

VIII. Authorized Official

Name: DR. ROBERT V NEWMAN
Title or Position: PARTNER
Credential: M.D.
Phone: 480-443-4437