Provider Demographics
NPI:1245290766
Name:EDWARD D SZMUC, M.D., P.C.
Entity type:Organization
Organization Name:EDWARD D SZMUC, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SZMUC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-820-9722
Mailing Address - Street 1:2034 E SOUTHERN AVE
Mailing Address - Street 2:SUITE T
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7522
Mailing Address - Country:US
Mailing Address - Phone:480-820-9722
Mailing Address - Fax:480-491-1359
Practice Address - Street 1:2034 E SOUTHERN AVE
Practice Address - Street 2:SUITE T
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7522
Practice Address - Country:US
Practice Address - Phone:480-820-9722
Practice Address - Fax:480-491-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14022207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ257768Medicaid
AZ257768Medicaid
AZD00406Medicare UPIN