Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 30953 | AZ |
Y | 208600000X | Surgeon | 30953 | AZ |
NPI | 1013941061 |
---|---|
Provider Name | Dr. Gowen Nirmul |
First Address | Scottsdale, AZ 85260-2686 |
Second Address | Sun City West, AZ 85375-6010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 07/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2Z1301 | HEALTHNET (01) | AZ |
AZ0753520 | BCBS (01) | AZ |
H82966 | (02) | AZ |