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Individual

JUSTIN SEROY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
(602) 200-6034
Mailing address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
(602) 200-6034

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
006635
AZ
207RI0200X
Infectious Disease Physician
036.132166
IL
390200000X
Student in an Organized Health Care Education/Training Program
125057500
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125057500
STATE LICENSE
IL
Enumeration date
08/31/2010
Last updated
08/23/2019
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