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Organization
SOUTHWESTERN ARIZONA NEONATOLOGY PLLC.
Active
Organization
SOUTHWESTERN ARIZONA NEONATOLOGY PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY ROBERT WARDA M.D. (NEONATOLOGY MEDICAL DIRECTOR,SWAN)
(928) 336-7665
Entity
Organization
Contact information
Practice address
2400 S AVENUE A, NICU, YUMA, AZ 85364-7127
(928) 336-7665
(928) 336-1559
Mailing address
PO BOX 50, YUMA, AZ 85366-0050
(928) 783-7283
(928) 783-4257
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
27466
AZ
2080N0001X
Neonatal-Perinatal Medicine Physician
33879
CO
2080N0001X
Neonatal-Perinatal Medicine Physician
C50724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330211
AHCCS APIPA
AZ
01
—
AZ078006
BLUE CROSS BLUE SHEILD
AZ
Enumeration date
07/16/2006
Last updated
05/20/2008
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