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Stephen Leo Roelof Jozef Isham, MEDICALSTUDENT
Student in an Organized Health Care Education/Training Program in Glendale, Arizona
NPI 1033801147

Stephen Leo Roelof Jozef Isham is a Student in an Organized Health Care Education/Training Program based in Coeur D Alene, AZ. Stephen Leo Roelof Jozef Isham practices in Glendale, AZ and has the professional credentials of MEDICALSTUDENT. The NPI Number for Stephen Leo Roelof Jozef Isham is 1033801147 and holds a License No. (Arizona).

The current practice location address for Stephen Leo Roelof Jozef Isham is 19555 N 59Th Ave, Glendale, AZ and can be reached out via phone at 623-572-3447.

Location: 19555 N 59Th Ave, Glendale, AZ, 83814-7165
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033801147
Provider Name
Stephen Leo Roelof Jozef Isham
Credential
MEDICALSTUDENT
Provider Entity Type
Individual
Gender
Male
Address
19555 N 59Th Ave, Glendale, AZ, 83814-7165
Phone Number
623-572-3447
Fax Number
Provider Enumeration Date
05/25/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
19555 N 59Th Ave
City
Glendale
State
Arizona
Zip
85308-6813
Phone Number
623-572-3447
Fax Number
person
Provider Business Mailing Address Details
Address
19555 N 59Th Ave
City
Glendale
State
Arizona
Zip
85308-6813
Phone Number
623-572-3447
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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