Healthcare Provider Details

I. General information

NPI: 1588192397
Provider Name (Legal Business Name): NORTH SCOTTSDALE ALLERGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2017
Last Update Date: 05/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6892 E IRONWOOD DR
SCOTTSDALE AZ
85266-7444
US

IV. Provider business mailing address

20701 N SCOTTSDALE RD STE 107
SCOTTSDALE AZ
85255-6413
US

V. Phone/Fax

Practice location:
  • Phone: 305-298-2832
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY MICHAEL COWAN
Title or Position: PARTNER
Credential: MD
Phone: 305-298-2832