Provider Demographics
NPI:1780653238
Name:ZWERIN, PETER ALAN (M D)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ALAN
Last Name:ZWERIN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 E SOUTHERN AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7669
Mailing Address - Country:US
Mailing Address - Phone:480-838-1555
Mailing Address - Fax:480-838-1777
Practice Address - Street 1:2501 E SOUTHERN AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7669
Practice Address - Country:US
Practice Address - Phone:480-838-1555
Practice Address - Fax:480-838-1777
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12533207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ225434Medicaid
AZ225434Medicaid