Provider Demographics
NPI:1093760423
Name:HOSHIWARA, STEVEN T (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:T
Last Name:HOSHIWARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10595 N TATUM BLVD STE E144
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1072
Mailing Address - Country:US
Mailing Address - Phone:480-907-7978
Mailing Address - Fax:480-588-7340
Practice Address - Street 1:10595 N TATUM BLVD STE E144
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253
Practice Address - Country:US
Practice Address - Phone:480-907-7978
Practice Address - Fax:480-588-7340
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ19075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ133174Medicaid
63712Medicare ID - Type Unspecified
AZ133174Medicaid