Provider Demographics
NPI:1609869502
Name:ZILTZER, ROBERT JAY (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAY
Last Name:ZILTZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10210 N 92ND ST
Mailing Address - Street 2:STE 104
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4509
Mailing Address - Country:US
Mailing Address - Phone:480-661-7161
Mailing Address - Fax:480-661-1434
Practice Address - Street 1:10210 N 92ND ST
Practice Address - Street 2:STE 104
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4509
Practice Address - Country:US
Practice Address - Phone:480-661-7161
Practice Address - Fax:480-661-1434
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18505207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ101080OtherAHCCCS
AZWMBNQOZMedicare ID - Type Unspecified
AZ101080OtherAHCCCS