Provider Demographics
NPI:1285670315
Name:NAZARETH, RONALD V (MD)
Entity Type:Individual
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First Name:RONALD
Middle Name:V
Last Name:NAZARETH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4747 N 7TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3653
Mailing Address - Country:US
Mailing Address - Phone:602-279-7655
Mailing Address - Fax:602-264-1806
Practice Address - Street 1:5701 W TALAVI BLVD
Practice Address - Street 2:SUITE 180
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1886
Practice Address - Country:US
Practice Address - Phone:623-486-8202
Practice Address - Fax:623-486-2739
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2012-07-06
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Provider Licenses
StateLicense IDTaxonomies
AZ138752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry