Individual
HENRY DALE TAZELAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5404
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
21209
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
21209
AZ
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
21209
AZ
Other
Enumeration date
12/07/2005
Last updated
10/08/2020
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