Provider Demographics
NPI:1578752093
Name:METRO ORTHOPEDIC SURGEONS LTD
Entity Type:Organization
Organization Name:METRO ORTHOPEDIC SURGEONS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-841-9720
Mailing Address - Street 1:3201 W PEORIA AVE STE A105
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4609
Mailing Address - Country:US
Mailing Address - Phone:602-841-9720
Mailing Address - Fax:602-841-9794
Practice Address - Street 1:3201 W PEORIA AVE STE A105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4609
Practice Address - Country:US
Practice Address - Phone:602-841-9720
Practice Address - Fax:602-841-9794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWCHMLOtherMEDICARE GROUP NUMBER
AZ=========OtherEIN
AZZWCHMLOtherMEDICARE GROUP NUMBER