Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 37282 | AZ |
NPI | 1023024841 |
---|---|
Provider Name | Dr. Elizabeth V Mahour-Moyer |
First Address | Glendale, AZ 85304-1259 |
Second Address | Glendale, AZ 85304-1259 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 19/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
636849 | (05) | AZ |
I33676 | (02) | NY |