Provider Demographics
NPI:1760658538
Name:CONTEMPORARY OBSTETRICS & GYNECOLOGY, PC
Entity Type:Organization
Organization Name:CONTEMPORARY OBSTETRICS & GYNECOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-770-7325
Mailing Address - Street 1:1976 E BASELINE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1533
Mailing Address - Country:US
Mailing Address - Phone:480-644-1911
Mailing Address - Fax:480-644-1916
Practice Address - Street 1:1976 E BASELINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1533
Practice Address - Country:US
Practice Address - Phone:480-644-1911
Practice Address - Fax:480-644-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14747207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ72184Medicare PIN