Individual
IRENE K TAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6525 W SACK DR STE 105, GLENDALE, AZ 85308-7106
(623) 888-5400
Mailing address
PO BOX 910221, DALLAS, TX 75391-0221
(520) 519-7700
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
26257
AZ
2085R0205X
Radiological Physics Physician
26257
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
418774
AHCCCS
AZ
Enumeration date
02/20/2006
Last updated
03/18/2022
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