Provider Demographics
NPI:1851380489
Name:OFFOMAH, NARIEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:NARIEL
Middle Name:C
Last Name:OFFOMAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32910
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-2910
Mailing Address - Country:US
Mailing Address - Phone:520-751-0360
Mailing Address - Fax:520-751-2521
Practice Address - Street 1:6567 E CARONDELET DR STE 441
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2156
Practice Address - Country:US
Practice Address - Phone:520-751-0360
Practice Address - Fax:520-751-2521
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ32214207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ869373Medicaid
AZ869373Medicaid
I11741Medicare UPIN