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General NPI Number Information
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NPI Number | 1548806276
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Entity Type | Organization
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Legal Business Name | ARIZONA MOBILE DERMATOLOGY AND WOUND CARE PLC
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 7301 E 2ND ST STE 200
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-5610
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Country | US
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Telephone | 602-418-8766
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Fax |
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Provider Business Mailing Address
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Address Line | 6535 N ARIZONA BILTMORE CIR
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City | PHOENIX
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State | AZ
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Zip | 85016-8907
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Country | US
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Telephone | 602-417-8766
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | NEIL PETER SUPERFON
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Credential | D.O
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Telephone | 602-417-8766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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