Provider Demographics
NPI:1336188093
Name:DUARTE, IRENE S (MD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:S
Last Name:DUARTE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5055 E BROADWAY BLVD STE A100
Mailing Address - Street 2:ARIZONA COMMUNITY PHYSICIAN PC
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3629
Mailing Address - Country:US
Mailing Address - Phone:520-547-4906
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:2055 W HOSPITAL DR STE 255
Practice Address - Street 2:NORTHWEST MEDICAL GROUP
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7857
Practice Address - Country:US
Practice Address - Phone:520-547-5725
Practice Address - Fax:520-547-5735
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-02-06
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Provider Licenses
StateLicense IDTaxonomies
AZ21997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F87653Medicare UPIN