Provider Demographics
NPI:1245248533
Name:CARFAGNO, DAVID G (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:CARFAGNO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:10133 N 92ND ST STE 102
Mailing Address - Street 2:SCOTTSDALE
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4556
Mailing Address - Country:US
Mailing Address - Phone:480-664-4615
Mailing Address - Fax:480-664-4367
Practice Address - Street 1:10133 N 92ND ST STE 102
Practice Address - Street 2:SCOTTSDALE
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4556
Practice Address - Country:US
Practice Address - Phone:480-664-4615
Practice Address - Fax:480-664-4367
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAZ3227207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZHH01978Medicare UPIN
AZZ80722Medicare PIN