Organization
ARIZONA MOBILE DERMATOLOGY AND WOUND CARE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL PETER SUPERFON D.O (OWNER/PROVIDER)
(602) 417-8766
Entity
Organization
Contact information
Practice address
7301 E 2ND ST STE 200, SCOTTSDALE, AZ 85251-5610
(602) 418-8766
Mailing address
6535 N ARIZONA BILTMORE CIR, PHOENIX, AZ 85016-8907
(602) 417-8766
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0754
AZ MEDICAL LICENSE NUMBER
AZ
Enumeration date
11/18/2019
Last updated
03/07/2023
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