Provider Demographics
NPI:1598706939
Name:SUN VALLEY ORTHOPEDIC SURGEONS GENERAL PARTNERSHIP
Entity Type:Organization
Organization Name:SUN VALLEY ORTHOPEDIC SURGEONS GENERAL PARTNERSHIP
Other - Org Name:SUNVALLEY ORTHOPAEDIC & HAND SURGEONS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:STERUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-584-5626
Mailing Address - Street 1:12361 W BOLA DR
Mailing Address - Street 2:STE 100
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378
Mailing Address - Country:US
Mailing Address - Phone:623-584-5626
Mailing Address - Fax:623-584-8998
Practice Address - Street 1:12361 W BOLA DR
Practice Address - Street 2:STE 100
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9021
Practice Address - Country:US
Practice Address - Phone:623-584-5626
Practice Address - Fax:623-584-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207X00000X
AZ11425207XS0106X
207XS0114X
AZ4221207XS0114X
AZ34748207XS0114X
AZ13525207XS0117X
AZ35083207XX0005X
AZ665213ES0103X
AZ0892225100000X
AZ1444225100000X
AZ3597363A00000X
AZ3122363A00000X
AZF0604150363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCN1748OtherRAILROAD MEDICARE
AZP0298960OtherBC/BS PHYSICAL THERAPY
AZCN1748OtherRAILROAD MEDICARE
AZ0321470001Medicare NSC