Provider Demographics
NPI: | 1457362113 |
---|---|
Name: | POSADAS, MARIA S (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | MARIA |
Middle Name: | S |
Last Name: | POSADAS |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | MA. SOCORRO |
Other - Middle Name: | DINA F |
Other - Last Name: | BATOON POSADAS |
Other - Suffix: | |
Other - Last Name Type: | Other Name |
Other - Credentials: | MD |
Mailing Address - Street 1: | PO BOX 31235 |
Mailing Address - Street 2: | |
Mailing Address - City: | TUCSON |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85751-1235 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 520-324-4100 |
Mailing Address - Fax: | 520-324-1406 |
Practice Address - Street 1: | 2380 N FERGUSON AVE STE 104 |
Practice Address - Street 2: | |
Practice Address - City: | TUCSON |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85712-2837 |
Practice Address - Country: | US |
Practice Address - Phone: | 520-324-1010 |
Practice Address - Fax: | 520-324-0029 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-08-10 |
Last Update Date: | 2019-09-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AZ | 35890 | 207RE0101X, 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AZ | Z141578 | Other | MEDICARE PTAN |