Healthcare Provider Details
I. General information
NPI: 1669447132
Provider Name (Legal Business Name): NORMAN ZITOMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/20/2006
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8573 E PRINCESS DR STE. B215
SCOTTSDALE AZ
85255-7819
US
IV. Provider business mailing address
PO BOX 11128
TACOMA WA
98411-0128
US
V. Phone/Fax
- Phone: 480-563-5757
- Fax: 480-563-5851
- Phone: 253-272-8148
- Fax: 253-404-0506
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | 33837 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: