Provider Demographics
NPI:1336418367
Name:PODOLSKY, HOWARD SCOTT (MD JD MBA FCLM)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:SCOTT
Last Name:PODOLSKY
Suffix:
Gender:M
Credentials:MD JD MBA FCLM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6165 W DETROIT ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2633
Mailing Address - Country:US
Mailing Address - Phone:480-499-8772
Mailing Address - Fax:
Practice Address - Street 1:6165 W DETROIT ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2633
Practice Address - Country:US
Practice Address - Phone:480-499-8772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44901207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine