Organization
ARIZONA WELLNESS ANESTHESIA GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IGOR KRAVCHENKO MD (OWNER)
(602) 595-5145
Entity
Organization
Contact information
Practice address
6005 S 36TH ST, PHOENIX, AZ 85042-4901
(602) 595-5145
(602) 595-5302
Mailing address
6005 S 36TH ST, PHOENIX, AZ 85042-4901
(602) 595-5145
(602) 595-5302
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
37002
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
354648
—
AZ
Enumeration date
07/10/2008
Last updated
05/10/2016
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