Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 17145 | AZ |
N | 207RA0201X | Internist - Allergy & Immunology | 17145 | AZ |
NPI | 1245270230 |
---|---|
Provider Name | Dr. Allan M Wachter |
First Address | Phoenix, AZ 85044-2700 |
Second Address | Phoenix, AZ 85044-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 12/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1Z3872 | HEALTH NET AZ (01) | AZ |
27995201 | (05) | AZ |
826036 | AETNA (01) | AZ |
AZ0807640 | BCBS (01) | AZ |