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NPI Code Detail

MEDICARE: EUGENE ERWIN

MEDICARE: EUGENE ERWIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistD011092AZ
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1033745377
Entity Type Code : Individual
Provider Name (Legal Business Name) : EUGENE ERWIN
Provider Business Mailing Address
First Line : 839 W CONGRESS ST
Second Line :
City : TUCSON
State : AZ
Zip : 85745-2819
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3440 E BASELINE RD STE 106
Second Line :
City : MESA
State : AZ
Zip : 85204-7247
Country : US
Telephone Number : 480-926-2350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2020
Last Update Date : 07/09/2021

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Directions to “ EUGENE ERWIN ” Practice Location

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