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Gary Lee Waddington, MD

Dermatology in Surprise, AZ. Individual provider (NPI-1).

NPI number1033103643
StatusActive
Last updated in NPPESMay 15, 2013

Details

NPI
1033103643
Entity type
Individual (NPI-1)
Name
Gary Lee Waddington
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Sep 9, 2005
Last updated
May 15, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X Dermatology12916AZYes
207KA0200X Allergy & Immunology, Allergy12916AZ
207K00000X Allergy & Immunology12916AZ
207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology12916AZ
207NS0135X Dermatology, Procedural Dermatology12916AZ
207ND0900X Dermatology, Dermatopathology12916AZ
207ND0101X Dermatology, MOHS-Micrographic Surgery12916AZ
207NP0225X Dermatology, Pediatric Dermatology12916AZ

Practice location

14239 W Bell Rd
Suite 101
Surprise, AZ 85374-2469

Phone 623-544-7755 · Fax 623-544-8665

Mailing address

14239 W Bell Rd
Suite 101
Surprise, AZ 85374-2469

Phone 623-544-7755 · Fax 623-544-8665

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