MEDICARE: DR. NATHANIEL ZONERAICH MD

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
1	207VE0102X	Reproductive Endocrinology Physician	33844	AZ

General Provider Information

NPI Number	:	1316949621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHANIEL ZONERAICH MD

Provider Business Mailing Address
First Line	:	9819 N 95TH ST
Second Line	:	105
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4588
Country	:	US
Telephone Number	:	480-874-2229
Fax Number	:	480-874-2231

Provider Business Practice Location Address
First Line	:	9819 N 95TH ST STE 105
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4588
Country	:	US
Telephone Number	:	480-874-2229
Fax Number	:	480-874-2231

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	12/09/2023

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