Basic Information
Provider Information
NPI: 1366466633
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAPEZ
FirstName: ANDREW
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3200 E CAMELBACK RD STE 250
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850182327
CountryCode: US
TelephoneNumber: 6029331814
FaxNumber:  
Practice Location
Address1: 1919 E THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850167710
CountryCode: US
TelephoneNumber: 6029333366
FaxNumber: 6029334166
Other Information
ProviderEnumerationDate: 07/27/2006
LastUpdateDate: 09/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301081979MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
208000000X4301081979MIN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0202X4301081979MIN Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
2080P0202X36711AZY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

No ID Information.


Home