Healthcare Provider Details

I. General information

NPI: 1811149925
Provider Name (Legal Business Name): SUMMIT FOOT AND ANKLE SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 02/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 N SCOTTSDALE RD SUITE 604
SCOTTSDALE AZ
85254-5216
US

IV. Provider business mailing address

10900 N SCOTTSDALE RD SUITE 604
SCOTTSDALE AZ
85254-5216
US

V. Phone/Fax

Practice location:
  • Phone: 480-928-2111
  • Fax: 480-383-6042
Mailing address:
  • Phone: 480-928-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRUCE R. WERBER
Title or Position: MANAGING PARTNER
Credential: DPM
Phone: 480-948-2111