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NPI Code Detail

MEDICARE: MARK MORALES MD

MEDICARE: MARK MORALES MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician14795AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083684864
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK MORALES MD
Provider Business Mailing Address
First Line : 4375 E IRMA LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85050-4312
Country : US
Telephone Number : 480-890-5800
Fax Number :
Provider Business Practice Location Address
First Line : 4375 E IRMA LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85050-4312
Country : US
Telephone Number : 480-890-5800
Fax Number : 480-890-5920
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 10/14/2024

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