Individual
IV GODZDANKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5808
(602) 344-5907
Mailing address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
54281
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/03/2014
Last updated
09/15/2020
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