=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407826985
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GREGORY R CURVAN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2006
-----------------------------------------------------
Last Update Date | 01/03/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 635 E BASELINE RD
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85042-6551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-243-7277
-----------------------------------------------------
Fax | 602-243-1235
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5040 N 15TH AVE STE 104
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85015-3329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-846-6957
-----------------------------------------------------
Fax | 623-849-2055
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 30609
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------