Healthcare Provider Details
I. General information
NPI: 1184194060
Provider Name (Legal Business Name): HONORHEALTH AMBULATORY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/04/2018
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10200 N 92ND ST STE 200
SCOTTSDALE AZ
85258-4543
US
IV. Provider business mailing address
2500 W UTOPIA RD STE 100
PHOENIX AZ
85027-4172
US
V. Phone/Fax
- Phone: 480-882-7410
- Fax: 480-451-9098
- Phone: 480-587-5314
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAVAS
PETRIDES
Title or Position: SVP/CEO
Credential:
Phone: 480-696-4020