Healthcare Provider Details

I. General information

NPI: 1245290766
Provider Name (Legal Business Name): EDWARD D SZMUC, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2034 E SOUTHERN AVE SUITE T
TEMPE AZ
85282-7522
US

IV. Provider business mailing address

2034 E SOUTHERN AVE SUITE T
TEMPE AZ
85282-7522
US

V. Phone/Fax

Practice location:
  • Phone: 480-820-9722
  • Fax: 480-491-1359
Mailing address:
  • Phone: 480-820-9722
  • Fax: 480-491-1359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number14022
License Number StateAZ

VIII. Authorized Official

Name: DR. EDWARD D SZMUC
Title or Position: PRESIDENT
Credential: M.D.
Phone: 480-820-9722