Healthcare Provider Details

I. General information

NPI: 1053898692
Provider Name (Legal Business Name): HONORHEALTH AMBULATORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 N SCOTTSDALE RD STE 603
SCOTTSDALE AZ
85254-5252
US

IV. Provider business mailing address

2500 W UTOPIA RD
PHOENIX AZ
85027-4171
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-7470
  • Fax: 480-922-2472
Mailing address:
  • Phone: 480-696-4020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: SAVAS PETRIDES
Title or Position: SVP/CEO
Credential:
Phone: 480-696-4020