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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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