Provider Demographics
NPI:1962509448
Name:TARLOW, STEFAN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:DAVID
Last Name:TARLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8630 E VIA DE VENTURA STE 105
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3340
Mailing Address - Country:US
Mailing Address - Phone:480-483-0393
Mailing Address - Fax:480-237-9473
Practice Address - Street 1:8630 E VIA DE VENTURA STE 105
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3340
Practice Address - Country:US
Practice Address - Phone:480-483-0393
Practice Address - Fax:480-237-9473
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMD34257207X00000X
AZ34257207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730330234OtherORGANIZATIONAL NPI
AZZ173457Medicare PIN
AZC75526Medicare UPIN