Provider Demographics
NPI:1164410627
Name:MARIC, ZORAN (MD)
Entity Type:Individual
Prefix:
First Name:ZORAN
Middle Name:
Last Name:MARIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W THOMAS RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4417
Mailing Address - Country:US
Mailing Address - Phone:602-274-0480
Mailing Address - Fax:602-274-2271
Practice Address - Street 1:333 W THOMAS RD
Practice Address - Street 2:#202
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4417
Practice Address - Country:US
Practice Address - Phone:602-274-0480
Practice Address - Fax:602-274-2271
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20848207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ115289Medicaid
AZ3Z3920OtherHEALTHNET
AZ3Z3920OtherHEALTHNET
AZF35578Medicare UPIN
AZ115289Medicaid