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General NPI Number Information
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NPI Number | 1053663336
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Entity Type | Organization
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Legal Business Name | STEVEN B MCRUNELS DO PC
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 4350 N 19TH AVE STE 7
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City | PHOENIX
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State | AZ
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Zip | 85015-4602
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Country | US
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Telephone | 602-532-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 4350 N 19TH AVE STE 7
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City | PHOENIX
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State | AZ
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Zip | 85015-4602
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Country | US
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Telephone | 602-532-9300
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Fax |
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Authorized Official
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Title or Position | BILLING REP.
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Name | NORMA ANAYA
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Credential |
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Telephone | 602-532-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2947
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License Number State | AZ
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