Provider Demographics
NPI:1639146335
Name:WESTERFIELD, EDWARD (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:WESTERFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:R
Other - Middle Name:EDWARD
Other - Last Name:WESTERFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 7118
Mailing Address - Street 2:NORTH VALLEY ANESTHESIA
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-7118
Mailing Address - Country:US
Mailing Address - Phone:480-899-1711
Mailing Address - Fax:480-857-6601
Practice Address - Street 1:250 E DUNLAP
Practice Address - Street 2:JOHN C LINCOLN HOSPITAL NORTH MOUNTAIN
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020
Practice Address - Country:US
Practice Address - Phone:602-943-2381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17798207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ27857401Medicaid
AZAZ0360010OtherBCBS
AZ27857401Medicaid
AZAZ0360010OtherBCBS