Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 29886 | AZ |
N | 208600000X | Surgeon | 29886 | AZ |
Y | 2086S0102X | Surgical Critical Care | 29886 | AZ |
N | 2086S0127X | Trauma Surgeon | 29886 | AZ |
NPI | 1093759789 |
---|---|
Provider Name | Dr. Thomas M Wertin |
First Address | Phoenix, AZ 85008-4973 |
Second Address | Phoenix, AZ 85008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 25/09/2018 |