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Individual

SCOTT MATTHEW HARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(602) 262-8917
(602) 262-8890
Mailing address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(602) 262-8917
(602) 262-8890

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036120178
IL
207L00000X
Anesthesiology Physician
53084
WI
207L00000X
Anesthesiology Physician
Primary
60393
AZ
207L00000X
Anesthesiology Physician
A105704
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036120178
IL MEDICAL LICENSE
IL
01
53084
WI STATE LICENSE
WI
Enumeration date
06/27/2007
Last updated
10/01/2021
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