Provider Demographics
NPI:1215009162
Name:MROZ BAIER BREAST CARE CLINIC, PC
Entity Type:Organization
Organization Name:MROZ BAIER BREAST CARE CLINIC, PC
Other - Org Name:DR. CHRISTINE MROZ, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER, AO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MROZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-527-3391
Mailing Address - Street 1:6005 PARK AVE
Mailing Address - Street 2:#700
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5217
Mailing Address - Country:US
Mailing Address - Phone:901-527-3391
Mailing Address - Fax:901-578-3969
Practice Address - Street 1:6005 PARK AVE
Practice Address - Street 2:#700
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5217
Practice Address - Country:US
Practice Address - Phone:901-527-3391
Practice Address - Fax:901-578-3969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty