Healthcare Provider Details

I. General information

NPI: 1790903813
Provider Name (Legal Business Name): SCOTTSDALE WOMEN'S CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 E 2ND ST SUITE #310
SCOTTSDALE AZ
85251-5600
US

IV. Provider business mailing address

7301 E 2ND ST SUITE #310
SCOTTSDALE AZ
85251-5600
US

V. Phone/Fax

Practice location:
  • Phone: 480-947-8090
  • Fax: 480-947-1712
Mailing address:
  • Phone: 480-947-8090
  • Fax: 480-947-1712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number32700
License Number StateAZ

VIII. Authorized Official

Name: MRS. SALLY T. WAREING
Title or Position: OWNER
Credential: M.D.
Phone: 480-947-8090