Provider Demographics
NPI:1225050164
Name:HATAM, MARIE F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:F
Last Name:HATAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 W CAREFREE HWY
Mailing Address - Street 2:STE. 700-1
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3201
Mailing Address - Country:US
Mailing Address - Phone:623-245-6695
Mailing Address - Fax:
Practice Address - Street 1:3120 W CAREFREE HWY
Practice Address - Street 2:STE. 700-1
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086
Practice Address - Country:US
Practice Address - Phone:623-245-6695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34517261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine