Provider Demographics
NPI:1205054855
Name:DESERT NEONATOLOGY ASSOCIATES
Entity type:Organization
Organization Name:DESERT NEONATOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:COVEA
Authorized Official - Last Name:MCQUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-476-8962
Mailing Address - Street 1:7720 N 16TH ST
Mailing Address - Street 2:STE 425
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4492
Mailing Address - Country:US
Mailing Address - Phone:602-476-8962
Mailing Address - Fax:623-643-9236
Practice Address - Street 1:7720 N 16TH ST
Practice Address - Street 2:STE 425
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4492
Practice Address - Country:US
Practice Address - Phone:602-476-8962
Practice Address - Fax:623-643-9236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty