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NPI Code Detail

MEDICARE: DR. SHIRLEY C F NORONHA MD

MEDICARE: DR. SHIRLEY C F NORONHA 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
1207R00000XInternal Medicine Physician43800AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z143368OTHERAZMEDICARE INDIVIDUAL PTAN
2Z143367OTHERAZMEDICARE GROUP PTAN

General Provider Information

NPI Number : 1467566141
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHIRLEY C F NORONHA MD
Provider Business Mailing Address
First Line : PO BOX 147
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86405-0147
Country : US
Telephone Number : 928-680-4233
Fax Number : 928-680-6522
Provider Business Practice Location Address
First Line : 2082 MESQUITE AVE
Second Line : SUITE 106
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-6710
Country : US
Telephone Number : 928-680-4233
Fax Number : 928-680-6522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 02/09/2016

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Directions to “ DR. SHIRLEY C F NORONHA MD” Practice Location

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