Provider Demographics
NPI:1235249251
Name:NAZAROFF, ANTHONY ALEXANDER (MD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ALEXANDER
Last Name:NAZAROFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6565 E CARONDELET DR STE 155
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-3587
Mailing Address - Country:US
Mailing Address - Phone:520-849-8900
Mailing Address - Fax:520-849-7137
Practice Address - Street 1:6565 E CARONDELET DR STE 155
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710
Practice Address - Country:US
Practice Address - Phone:520-849-8900
Practice Address - Fax:520-849-7137
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ27092208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ77308Medicare PIN
AZG34199Medicare UPIN