Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 25428 | AZ |
Y | 207RI0011X | Interventional Cardiology | 25428 | AZ |
NPI | 1063476372 |
---|---|
Provider Name | John P Sweeney |
First Address | Phoenix, AZ 85054-4502 |
Second Address | Phoenix, AZ 85054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 03/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G55427 | (02) |