Provider Demographics
NPI:1770828477
Name:OSBORN OB GYN WOMENS CARE PC
Entity Type:Organization
Organization Name:OSBORN OB GYN WOMENS CARE PC
Other - Org Name:PAULA NADELL, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:NADELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-234-0550
Mailing Address - Street 1:3411 N 5TH AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3812
Mailing Address - Country:US
Mailing Address - Phone:602-234-1333
Mailing Address - Fax:602-234-3142
Practice Address - Street 1:3411 N 5TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3812
Practice Address - Country:US
Practice Address - Phone:602-234-1333
Practice Address - Fax:602-234-3142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11784174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ0000BGKMRMedicare PIN
AZD00023Medicare UPIN