Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 23177 | AZ |
NPI | 1144281650 |
---|---|
Provider Name | Ryan Blaine Tsujimura |
First Address | Scottsdale, AZ 85260-1680 |
Second Address | Scottsdale, AZ 85260-1680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2006 |
Last Update Date | 05/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AZ0721130 | BCBS (01) | AZ |
G98338 | (02) |