Provider Demographics
NPI:1134192248
Name:ZACHEIS, DAVID HENRY (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:HENRY
Last Name:ZACHEIS
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 1:9097 E DESERT COVE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6280
Mailing Address - Country:US
Mailing Address - Phone:480-614-5406
Mailing Address - Fax:480-214-9929
Practice Address - Street 1:395 N SILVERBELL RD STE 201
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2719
Practice Address - Country:US
Practice Address - Phone:520-792-2170
Practice Address - Fax:520-792-9702
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43544207Y00000X
AZ49389207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO72756764Medicaid
AZ49389OtherARIZONA MEDICAL BOARD
802258Medicare ID - Type Unspecified