Basic Information
Provider Information
NPI: 1033404314
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MENZER
FirstName: HEATHER
MiddleName:  
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Mailing Information
Address1: 3200 E CAMELBACK RD STE 250
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850182327
CountryCode: US
TelephoneNumber: 6029331814
FaxNumber:  
Practice Location
Address1: MSC10 5600
Address2: 1 UNIVERSITY OF NEW MEXICO
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052724107
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/14/2011
LastUpdateDate: 03/23/2018
NPIDeactivationReasonCode:  
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ProviderGenderCode: F
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207X00000X54044AZY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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