Provider Demographics
NPI:1780046631
Name:WARRINGTON, STEPHANIE DIANA (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DIANA
Last Name:WARRINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 E SHEA BLVD STE 180
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6042
Mailing Address - Country:US
Mailing Address - Phone:602-264-4834
Mailing Address - Fax:602-257-8319
Practice Address - Street 1:5750 W THUNDERBIRD RD STE A100
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4661
Practice Address - Country:US
Practice Address - Phone:602-938-3205
Practice Address - Fax:602-938-5799
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ66160207Y00000X, 207YS0123X
390200000X
VA0101271992207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program