Provider Demographics
NPI:1326481102
Name:AZURDIA, ADRIENNE R (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:R
Last Name:AZURDIA
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 1:4237 E LIBERTY LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0537
Mailing Address - Country:US
Mailing Address - Phone:480-495-0843
Mailing Address - Fax:
Practice Address - Street 1:4237 E LIBERTY LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0537
Practice Address - Country:US
Practice Address - Phone:480-495-0843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2016-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52644207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine