Provider Demographics
NPI:1790903813
Name:SCOTTSDALE WOMEN'S CARE, P.C.
Entity Type:Organization
Organization Name:SCOTTSDALE WOMEN'S CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:T
Authorized Official - Last Name:WAREING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-947-8090
Mailing Address - Street 1:7301 E 2ND ST
Mailing Address - Street 2:SUITE #310
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5600
Mailing Address - Country:US
Mailing Address - Phone:480-947-8090
Mailing Address - Fax:480-947-1712
Practice Address - Street 1:7301 E 2ND ST
Practice Address - Street 2:SUITE #310
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5600
Practice Address - Country:US
Practice Address - Phone:480-947-8090
Practice Address - Fax:480-947-1712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32700207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ82758Medicare PIN
AZF00801Medicare UPIN