MEDICARE: DR. EUGENE EIHAUSEN NMD

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	175F00000X	Naturopath	02695	AZ

General Provider Information

NPI Number	:	1902929821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENE EIHAUSEN NMD

Provider Business Mailing Address
First Line	:	6341 W TETHER TRL
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85310-1006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6341 W TETHER TRL
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85310-1006
Country	:	US
Telephone Number	:	602-750-2992
Fax Number	:

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

Provider Enumeration Date	:	04/07/2007
Last Update Date	:	07/08/2007

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