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Individual

ILANA DORIS-RUTH WEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
16601 N 40TH ST STE 204, PHOENIX, AZ 85032-3356
(602) 996-4747
(602) 953-5466
Mailing address
16601 N 40TH ST STE 204, PHOENIX, AZ 85032-3356
(602) 996-4747
(602) 953-5466

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33656
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
915902
AZ
01
AZ0770430
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
06/28/2005
Last updated
07/21/2022
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