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Individual

DR. STEPHEN CHARLES SIROTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5501 N 19TH AVE STE 111, PHOENIX, AZ 85015-2451
(602) 288-7267
Mailing address
5501 N 19TH AVE STE 111, PHOENIX, AZ 85015-2451
(602) 288-7267

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
50242
AZ
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
50242
AZ
208VP0014X
Interventional Pain Medicine Physician
Primary
50242
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
099987
AZ
Enumeration date
09/23/2005
Last updated
09/06/2023
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