Provider Demographics
NPI:1699769877
Name:WAREING, SALLY T (MD)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:T
Last Name:WAREING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7301 E 2ND ST
Mailing Address - Street 2:STE. 310
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5600
Mailing Address - Country:US
Mailing Address - Phone:480-947-8090
Mailing Address - Fax:480-947-1712
Practice Address - Street 1:7301 E 2ND ST
Practice Address - Street 2:STE. 310
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5600
Practice Address - Country:US
Practice Address - Phone:480-947-8090
Practice Address - Fax:480-947-1712
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ32700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ869852Medicaid
AZ82758Medicare ID - Type Unspecified
AZ869852Medicaid