Provider Demographics
NPI:1255939286
Name:SEWELL ARAYA, JOSEPH MARCONNI (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MARCONNI
Last Name:SEWELL ARAYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11920 BAYPOINT DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-3367
Mailing Address - Country:US
Mailing Address - Phone:952-288-6026
Mailing Address - Fax:
Practice Address - Street 1:11920 BAYPOINT DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-3367
Practice Address - Country:US
Practice Address - Phone:952-288-6026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307478208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology