Individual
DR. NICHOLAS LARRY DEEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5452
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5499
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
49515
AZ
207Y00000X
Otolaryngology Physician
R73739
AZ
390200000X
Student in an Organized Health Care Education/Training Program
291937
NY
Other
Enumeration date
05/01/2013
Last updated
09/30/2020
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