Provider Demographics
NPI:1033570304
Name:RADULOVIC, MARIA (NP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:RADULOVIC
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9590 E IRONWOOD SQUARE DR
Mailing Address - Street 2:STE 125
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4583
Mailing Address - Country:US
Mailing Address - Phone:480-455-3000
Mailing Address - Fax:
Practice Address - Street 1:1515 N 9TH ST
Practice Address - Street 2:STE B
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2523
Practice Address - Country:US
Practice Address - Phone:602-258-9859
Practice Address - Fax:480-214-9945
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily