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Individual

WILLEM J VAN DER WERF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2218 N 3RD ST, PHOENIX, AZ 85004-1401
(602) 252-2543
(602) 252-3861
Mailing address
2218 N 3RD ST, PHOENIX, AZ 85004-1401
(602) 252-2543
(602) 252-3861

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
5249271205
UT
204F00000X
Transplant Surgery Physician
Primary
49927
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119626000
WY
01
4658850
CIGNA
01
52492781200001
BLUE CROSS BLUE SHIELD
05
806894300
ID
01
QM000006442
ALTIUS
01
TPRA07781
MOLINA
Enumeration date
07/04/2006
Last updated
11/12/2024
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