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General NPI Number Information
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NPI Number | 1538694252
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Entity Type | Organization
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Legal Business Name | ARIZONA VALLEY MEDICINE PLLC
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 05/01/2017
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Provider Practice Location Address
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Address Line | 7550 N 19TH AVE SUITE 103
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City | PHOENIX
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State | AZ
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Zip | 85021-7980
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Country | US
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Telephone | 602-995-5909
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Fax | 602-864-9233
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Provider Business Mailing Address
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Address Line | 7550 N 19TH AVE SUITE 103
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City | PHOENIX
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State | AZ
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Zip | 85021-7980
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Country | US
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Telephone | 602-995-5909
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Fax | 602-864-9233
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Authorized Official
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Title or Position | PRESIDENTT/PROVIDER
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Name | DANIEL T ZOETEMAN
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Credential | M.D.
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Telephone | 602-995-5909
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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 |
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License Number State |
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