Healthcare Provider Details

I. General information

NPI: 1932425253
Provider Name (Legal Business Name): PREMIER CARE FOR WOMEN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14239 W BELL RD STE 200
SURPRISE AZ
85374-2469
US

IV. Provider business mailing address

14239 W BELL RD STE 200
SURPRISE AZ
85374-2469
US

V. Phone/Fax

Practice location:
  • Phone: 623-584-0800
  • Fax: 623-584-0312
Mailing address:
  • Phone: 623-584-0800
  • Fax: 623-584-0312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number3131
License Number StateAZ

VIII. Authorized Official

Name: DR. GARY NEWMAN
Title or Position: PHYSICIAN
Credential: MD
Phone: 623-584-0800