Search › Arizona › 363LF0000X
Erich Widemark, PHD, FNP-BC
NPI 1669468260 · on the registry since 2005
Practice
- Address
- 14415 W Mcdowell Rd
Goodyear
Goodyear, AZ 85395 - Phone
- (623) 512-4190
- Fax
- (623) 512-4194
- Organisation at this address
- Phat Tai Llc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 363LF0000X
363LF0000X
- Licence states on file
- AZ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2009-11-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona