Provider Demographics
NPI:1609818095
Name:PFITZER, TAWNYA SUZANNE (DPM)
Entity Type:Individual
Prefix:DR
First Name:TAWNYA
Middle Name:SUZANNE
Last Name:PFITZER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13065 W MCDOWELL RD
Mailing Address - Street 2:SUITE A-103
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-6439
Mailing Address - Country:US
Mailing Address - Phone:623-547-2800
Mailing Address - Fax:623-547-3083
Practice Address - Street 1:13065 W MCDOWELL RD
Practice Address - Street 2:SUITE A-103
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-6439
Practice Address - Country:US
Practice Address - Phone:623-547-2800
Practice Address - Fax:623-547-3083
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ580213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU95831Medicare UPIN
AZZ79808Medicare ID - Type Unspecified