Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 43236 | AZ |
Y | 208600000X | Surgeon | 43236 | AZ |
N | 2086S0105X | Surgery of the Hand | 43236 | AZ |
NPI | 1912027798 |
---|---|
Provider Name | Timothy Allen Schaub |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85016-7710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 24/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
536337 | (05) | AZ |