Individual
DR. STEVEN ROBERT KANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
5823 W EUGIE AVE, STE A, GLENDALE, AZ 85304-1276
(602) 843-1265
(602) 843-1297
Mailing address
3020 E CAMELBACK RD, SUITE 301, PHOENIX, AZ 85016-5095
(602) 264-9100
(602) 264-9101
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
10136
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120390
GROUP MEDICARE NUMBER
AZ
05
—
229890 01
—
AZ
05
—
229890-04
—
AZ
01
—
317047
GROUP MEDICAID NUMBER
AZ
Enumeration date
03/07/2006
Last updated
02/16/2017
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