Individual
EUGENE L SEVERINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13640 N PLAZA DEL RIO BLVD, STE 210, PEORIA, AZ 85381-4846
(623) 876-3830
(623) 876-3934
Mailing address
13640 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-4846
(623) 876-3800
(623) 972-9590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7861
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246125
—
AZ
Enumeration date
05/19/2006
Last updated
07/09/2007
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