Healthcare Provider Details

I. General information

NPI: 1407080666
Provider Name (Legal Business Name): SARA ELIZABETH WORDINGHAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA WORDINGHAM REDER M.D.

II. Dates (important events)

Enumeration Date: 05/03/2009
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259
US

IV. Provider business mailing address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5452
US

V. Phone/Fax

Practice location:
  • Phone: 480-301-8000
  • Fax:
Mailing address:
  • Phone: 480-301-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number46047
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: