Healthcare Provider Details

I. General information

NPI: 1427030188
Provider Name (Legal Business Name): SETH D OESCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8573 E PRINCESS DR. STE 219
SCOTTSDALE AZ
85255
US

IV. Provider business mailing address

8620 N 22ND AVE STE 200
PHEONIX AZ
85021
US

V. Phone/Fax

Practice location:
  • Phone: 480-515-3507
  • Fax: 480-515-3925
Mailing address:
  • Phone: 602-674-6501
  • Fax: 602-674-6512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number27907
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: