Individual
IGNAT IVANOV IGNATOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
13832 W GELDING DR, SURPRISE, AZ 85379-8352
(602) 451-7496
Mailing address
13832 W GELDING DR, SURPRISE, AZ 85379-8352
(602) 451-7496
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4024
AZ
Other
Enumeration date
11/15/2012
Last updated
01/04/2023
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