Individual
ERIKA WAVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
26958
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
480608
—
AZ
01
—
86080015085259A615
TRIWEST
AZ
Enumeration date
12/06/2005
Last updated
10/31/2007
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