Individual
MR. NEIL P. SUPERFON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7301 E 2ND ST STE 310, SCOTTSDALE, AZ 85251-5627
(602) 754-6075
(623) 230-6814
Mailing address
7301 E 2ND ST STE 310, SCOTTSDALE, AZ 85251-5627
(602) 754-6075
(623) 230-6814
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
754
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
754
AZ
207ND0900X
Dermatopathology Physician
754
AZ
207NS0135X
Procedural Dermatology Physician
754
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227860
—
AZ
01
—
2Z2527
HEALTHNET
AZ
01
—
4022597
AETNA
AZ
01
—
AZ0063290
BLUE CROSS
AZ
Enumeration date
05/25/2006
Last updated
03/28/2024
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