Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 12872 | AZ |
NPI | 1205174729 |
---|---|
Provider Name | Dr. Scott Alan Rovner |
First Address | Scottsdale, AZ 85250-7720 |
Second Address | Scottsdale, AZ 85250-7720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2013 |
Last Update Date | 17/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
160002389 | (02) | AZ |