Individual
STEVEN CARY SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20950 N TATUM BLVD, SUITE 308, PHOENIX, AZ 85050-4200
(480) 419-2280
(480) 419-2290
Mailing address
202950 N. TATUM BLVD., SUITE 308, PHOENIX, AZ 85050-4255
(480) 419-2280
(480) 419-2290
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
30664
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110570
MEDICARE GROUP ID
AZ
05
—
754053
—
AZ
01
—
Z110571
MEDICARE PROVIDER ID
AZ
Enumeration date
07/22/2005
Last updated
09/07/2011
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