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General NPI Number Information
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NPI Number | 1932253945
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Entity Type | Organization
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Legal Business Name | ARIZONA SPINE AND STROKE CENTER PLLC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 5505 W CHANDLER BLVD SUITE 11
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City | CHANDLER
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State | AZ
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Zip | 85226
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Country | US
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Telephone | 480-659-2571
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Fax | 480-659-2671
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Provider Business Mailing Address
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Address Line | 5505 W CHANDLER BLVD SUITE 11
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City | CHANDLER
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State | AZ
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Zip | 85226-3683
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Country | US
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Telephone | 480-659-2571
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Fax | 480-659-2671
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Authorized Official
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Title or Position | MEMBER
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Name | DR. WLADISLAW G FEDORIW
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Credential | MD
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Telephone | 480-659-2571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35835
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License Number State | AZ
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