Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 27100 | AZ |
NPI | 1063454932 |
---|---|
Provider Name | Walter Schell |
First Address | Phoenix, AZ 85034-7256 |
Second Address | Phoenix, AZ 85008-4948 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 28/11/2011 |