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Individual

DR. ERIC VANCE HASTRITER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5779 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5779 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2006-01503
NC
2084N0400X
Neurology Physician
Primary
43021
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
521071
AZ
Enumeration date
09/26/2006
Last updated
08/04/2010
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