Provider Demographics
NPI:1518134030
Name:MITCHEM-WESTBROOK, LAFRABYA NATAKA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAFRABYA
Middle Name:NATAKA
Last Name:MITCHEM-WESTBROOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAFRABYA
Other - Middle Name:NATAKA
Other - Last Name:MITCHEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7332 BRUTHERUS DRIVE
Mailing Address - Street 2:HANGAR 1
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:480-247-6482
Practice Address - Street 1:350 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4409
Practice Address - Country:US
Practice Address - Phone:602-406-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40320207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00654493OtherRR MEDICARE
AZ345796Medicaid
AZ345796Medicaid