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General NPI Number Information
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NPI Number | 1437452224
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Entity Type | Organization
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Legal Business Name | NORMAN M NAZARETH MD, PC
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Dates
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Enumeration Date | 12/16/2010
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 19829 N 27TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85027-4001
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Country | US
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Telephone | 623-931-0077
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Fax | 623-931-0088
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Provider Business Mailing Address
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Address Line | PO BOX 81349
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City | PHOENIX
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State | AZ
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Zip | 85069-1349
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Country | US
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Telephone | 623-931-1225
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Fax | 623-931-0088
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Authorized Official
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Title or Position | OWNER
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Name | DR. NORMAN M NAZARETH
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Credential | M.D.
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Telephone | 623-931-1225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 28892
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License Number State | AZ
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