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Individual
MR. KURT JAMES TENGBERG
Active
Individual
MR. KURT JAMES TENGBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2520
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39-81220
EVERCARE GROUP
AZ
05
—
829137
—
AZ
01
—
AW1436
HEALTHNET GROUP
AZ
Enumeration date
11/02/2005
Last updated
11/13/2007
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