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Organization
ELVIAM LLC
Active
Organization
ELVIAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM WUOLLET (OWNER, MD)
(623) 231-2443
Entity
Organization
Contact information
Practice address
22601 N 19TH AVE STE 100, PHOENIX, AZ 85027-1324
(623) 231-2443
Mailing address
22601 N 19TH AVE STE 100, PHOENIX, AZ 85027-1324
(623) 231-2443
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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