Provider Demographics
NPI:1154428415
Name:KWARK, JUNE A (MD)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:A
Last Name:KWARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 W. THUNDERBIRD ROAD
Mailing Address - Street 2:SUITE W202
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-5612
Mailing Address - Country:US
Mailing Address - Phone:602-678-1111
Mailing Address - Fax:602-678-7090
Practice Address - Street 1:5757 W. THUNDERBIRD ROAD
Practice Address - Street 2:SUITE W202
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-5612
Practice Address - Country:US
Practice Address - Phone:602-678-1111
Practice Address - Fax:602-678-7090
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2024-0299207V00000X
AZ22526207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology