Healthcare Provider Details

I. General information

NPI: 1831365105
Provider Name (Legal Business Name): AFFILIATED ALLERGY & PULMONARY SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34597 N 60TH ST SUITE 100
SCOTTSDALE AZ
85266-5240
US

IV. Provider business mailing address

34597 N 60TH ST SUITE 100
SCOTTSDALE AZ
85266-5240
US

V. Phone/Fax

Practice location:
  • Phone: 480-473-7800
  • Fax: 480-513-8704
Mailing address:
  • Phone: 480-473-7800
  • Fax: 480-513-8704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number25811
License Number StateAZ

VIII. Authorized Official

Name: GEORGE F GWINN
Title or Position: CEO
Credential: M.D.
Phone: 480-473-7800