Provider Demographics
NPI:1528090826
Name:SCHOTTSTAEDT, ELINOR A (MD)
Entity type:Individual
Prefix:DR
First Name:ELINOR
Middle Name:A
Last Name:SCHOTTSTAEDT
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 1:3301 N MILLER RD
Mailing Address - Street 2:160
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6431
Mailing Address - Country:US
Mailing Address - Phone:480-990-7200
Mailing Address - Fax:480-990-7331
Practice Address - Street 1:3301 N MILLER RD
Practice Address - Street 2:160
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6431
Practice Address - Country:US
Practice Address - Phone:480-990-7200
Practice Address - Fax:480-990-7331
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17735174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ281832Medicaid
AZ23360Medicare ID - Type Unspecified
AZ121568Medicare PIN
AZD37599Medicare UPIN