Basic Information
| Provider Information | |||||||||
| NPI: | 1447256060 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAZARETH | ||||||||
| FirstName: | NORMAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 41150 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6232999199 | ||||||||
| FaxNumber: | 4808394727 | ||||||||
| Practice Location | |||||||||
| Address1: | 2421 E SOUTHERN AVE | ||||||||
| Address2: | STE 1 | ||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6232999199 | ||||||||
| FaxNumber: | 4803518797 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2005 | ||||||||
| LastUpdateDate: | 02/10/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 28892 | AZ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.