Provider Demographics
NPI:1245252527
Name:WEBB, ERIN ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:WEBB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 E THOMAS RD
Mailing Address - Street 2:BUILDING 2108, SUITE 101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7710
Mailing Address - Country:US
Mailing Address - Phone:602-512-8030
Mailing Address - Fax:602-512-8161
Practice Address - Street 1:20325 N 51ST AVE
Practice Address - Street 2:BUILDING 3, SUITE 116
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5674
Practice Address - Country:US
Practice Address - Phone:623-972-5437
Practice Address - Fax:623-492-9421
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ31064208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ789290Medicaid
AZ789290Medicaid