Provider Demographics
NPI:1427016468
Name:GURLEY, MELISSA B (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:B
Last Name:GURLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14687
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-4687
Mailing Address - Country:US
Mailing Address - Phone:480-991-8100
Mailing Address - Fax:480-922-1028
Practice Address - Street 1:11209 N TATUM BLVD
Practice Address - Street 2:SUITE #110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3091
Practice Address - Country:US
Practice Address - Phone:602-248-8002
Practice Address - Fax:602-248-8399
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261742085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ430794OtherAHCCCS
AZ1Z7049OtherHEALTHNET
AZAZ0324990OtherBCBS
AZ430794OtherAHCCCS
AZ1Z7049OtherHEALTHNET