Basic Information
| Provider Information | |||||||||
| NPI: | 1750318424 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHRAFF | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2222 E. HIGHLAND AVE | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022574219 | ||||||||
| FaxNumber: | 6022578319 | ||||||||
| Practice Location | |||||||||
| Address1: | 2222 E. HIGHLAND AVE | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022644834 | ||||||||
| FaxNumber: | 6022545178 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2006 | ||||||||
| LastUpdateDate: | 08/31/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0204X | 35.085331 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine | 207YP0228X | 36508 | AZ | Y | Allopathic & Osteopathic Physicians | Otolaryngology | Pediatric Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 200594 | 05 | AZ | MEDICAID |