Healthcare Provider Details

I. General information

NPI: 1447719539
Provider Name (Legal Business Name): NOVA ANESTHESIOLOGISTS & PERIOPERATIVE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 03/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8102 E MCDOWELL RD STE 2A
SCOTTSDALE AZ
85257-3819
US

IV. Provider business mailing address

PO BOX 160
SCOTTSDALE AZ
85252-0160
US

V. Phone/Fax

Practice location:
  • Phone: 480-421-1014
  • Fax: 480-421-9697
Mailing address:
  • Phone: 480-272-8411
  • Fax: 480-361-1435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL JAMES TUTTLE
Title or Position: OWNER
Credential: DO
Phone: 480-272-8411