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General NPI Number Information
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NPI Number | 1497284590
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Entity Type | Individual
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Provider Name | REBECCA TIEMAN RIST DO
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Gender | Female
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 13400 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5499
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Country | US
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Telephone | 480-301-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 13400 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5499
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Country | US
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Telephone | 480-301-8000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 008480
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 8480
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2017018529
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License Number State | MO
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