Provider Demographics
NPI:1467690388
Name:MASON, MARIANNE TERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:TERESA
Last Name:MASON
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 1:9551 W COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85373-1725
Mailing Address - Country:US
Mailing Address - Phone:605-371-6244
Mailing Address - Fax:
Practice Address - Street 1:9551 W COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85373-1725
Practice Address - Country:US
Practice Address - Phone:605-371-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5697207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology