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General NPI Number Information
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NPI Number | 1851528657
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Entity Type | Organization
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Legal Business Name | THEODORE MARK CWYNAR, MD, PC
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 7331 E OSBORN DR STE 300
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6422
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Country | US
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Telephone | 480-946-5656
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Fax | 480-946-6077
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Provider Business Mailing Address
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Address Line | 7331 E OSBORN DR STE 300
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6422
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Country | US
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Telephone | 480-946-5656
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Fax | 480-946-6077
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Authorized Official
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Title or Position | PRESIDENT
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Name | THEODORE MARK CWYNAR
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Credential | M.D.
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Telephone | 480-946-5656
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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 | 10871
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License Number State | AZ
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