Healthcare Provider Details

I. General information

NPI: 1316949621
Provider Name (Legal Business Name): NATHANIEL ZONERAICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 12/09/2023
Certification Date: 12/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9819 N 95TH ST STE 105
SCOTTSDALE AZ
85258-4588
US

IV. Provider business mailing address

9819 N 95TH ST 105
SCOTTSDALE AZ
85258-4588
US

V. Phone/Fax

Practice location:
  • Phone: 480-874-2229
  • Fax: 480-874-2231
Mailing address:
  • Phone: 480-874-2229
  • Fax: 480-874-2231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number33844
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: