Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 14352 | AZ |
N | 207Q00000X | Family Doctor | 14352 | AZ |
NPI | 1013153972 |
---|---|
Provider Name | Dr. Murray Manson |
First Address | Tucson, AZ 85718-3557 |
Second Address | Tucson, AZ 85718-3557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2008 |
Last Update Date | 26/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D01586 | (05) | AZ |
Z69164 | (02) | AZ |