Provider Demographics
NPI:1386680387
Name:ZUIDERWEG, RON (DO)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:
Last Name:ZUIDERWEG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3333 E CAMELBACK RD
Mailing Address - Street 2:STE 180
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2322
Mailing Address - Country:US
Mailing Address - Phone:302-997-0484
Mailing Address - Fax:602-224-3315
Practice Address - Street 1:6622 N 91ST AVE STE 200
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-2569
Practice Address - Country:US
Practice Address - Phone:623-547-4668
Practice Address - Fax:623-535-7869
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13277025-1204207RN0300X
AZ4370207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ145467Medicaid
AZ4370OtherAZ MEDICAL LICENSE
I55413Medicare UPIN
AZ145467Medicaid