Derusso, Stephanie Joan

Derusso, Stephanie Joan is an individual health care provider with primary practice located at 1634 S Priest Dr Ste 101 , Tempe AZ 85281-6499. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Derusso, Stephanie Joan can be contacted via phone (480) 821-3600.

Contact Information

Primary practice address
1634 S Priest Dr Ste 101 Tempe AZ 85281-6499
Phone: (480) 821-3600
Fax: (480) 345-2003
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 8163 Arizona

Profile Details

NPI number 1851779607
LBN Legal business name Derusso, Stephanie Joan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2015
Last updated May 30th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851779607 NPPES
Arizona MEDICAID 577776

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