Provider Demographics
NPI:1255522082
Name:SOLOMAN, MARC M (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:M
Last Name:SOLOMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARCOS
Other - Middle Name:M
Other - Last Name:SOLIMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14445 W MCDOWELL RD STE A104
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2518
Mailing Address - Country:US
Mailing Address - Phone:623-232-8787
Mailing Address - Fax:623-232-2789
Practice Address - Street 1:14445 W MCDOWELL RD STE A104
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2518
Practice Address - Country:US
Practice Address - Phone:480-550-9393
Practice Address - Fax:480-591-0485
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43959207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2802079Medicaid
AZ624812Medicaid
Z147207Medicare PIN
OH2802079Medicaid