NPI | 1902370349 |
---|---|
Doing Business As | AZKIDSDOC PEDIATRICS |
Entity Type | Organization |
Authorized Contact | DWAYNE MICHAEL ST. JACQUES Owner/Physician 480-783-8964 |
Organization Subpart ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
Additional Taxonomies | 208000000X Pediatrics |
Enumeration Date | 2019-01-18 |
Last Update Date | 2019-01-18 |