Healthcare Provider Details

I. General information

NPI: 1134110885
Provider Name (Legal Business Name): STACEY L REMCHUK FEUER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACEY L REMCHUK MD

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 E SOUTHERN AVE STE 7
TEMPE AZ
85282-7612
US

IV. Provider business mailing address

PO BOX 41150
MESA AZ
85274-1150
US

V. Phone/Fax

Practice location:
  • Phone: 480-425-2160
  • Fax: 480-351-8797
Mailing address:
  • Phone: 480-425-2160
  • Fax: 480-351-8797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35036
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: