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General NPI Number Information
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NPI Number | 1376570267
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Entity Type | Organization
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Legal Business Name | PERINATAL & WOMEN'S CENTER
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1837 W GUADALUPE RD SUITE 114
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City | MESA
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State | AZ
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Zip | 85202-7442
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Country | US
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Telephone | 480-491-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 1837 W GUADALUPE RD SUITE 114
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City | MESA
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State | AZ
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Zip | 85202-7442
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Country | US
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Telephone | 480-491-1600
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DAVID A. NYBERG
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Credential | M.D.
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Telephone | 480-491-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 29769
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License Number State | AZ
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