Individual
DR. IGGY MAYBORODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.D.
Contact information
Practice address
4149 E BETSY LN, GILBERT, AZ 85296-9623
(480) 600-0807
Mailing address
4149 E BETSY LN, GILBERT, AZ 85296-9623
(480) 600-0807
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
099.0084660
VT
175F00000X
Naturopath
ND-535
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099.0084660
CREDENTIAL #
VT
01
—
NDF-535
STATE LICENSE
CA
Enumeration date
03/12/2012
Last updated
10/02/2013
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