Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 16708 | AZ |
NPI | 1083696751 |
---|---|
Provider Name | Dr. Lester E Mertz |
First Address | Scottsdale, AZ 85259-5404 |
Second Address | Scottsdale, AZ 85259-5404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 08/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D44259 | (02) |