Poulos, Andrew

Poulos, Andrew is an individual health care provider with primary practice located at 15810 S 45Th St Ste 110 , Phoenix AZ 85048-7695. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Poulos, Andrew can be contacted via phone (480) 763-7273.

Contact Information

Primary practice address
15810 S 45Th St Ste 110 Phoenix AZ 85048-7695
Phone: (480) 763-7273
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 15512 Arizona

Profile Details

NPI number 1912977992
LBN Legal business name Poulos, Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Aug 28th, 2019 - about 6 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 1912977992 NPPES
Arizona MEDICAID 171281

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