MEDICARE: MR. ZACHARY MARULLI SABER L.M.P.

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
1	174400000X	Specialist	MT-13970	AZ

General Provider Information

NPI Number	:	1780713040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ZACHARY MARULLI SABER L.M.P.

Provider Business Mailing Address
First Line	:	3861 N 1ST AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1301
Country	:	US
Telephone Number	:	520-209-1755
Fax Number	:	520-798-2468

Provider Business Practice Location Address
First Line	:	3861 N 1ST AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1301
Country	:	US
Telephone Number	:	520-209-1755
Fax Number	:	520-798-2468

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	09/11/2012

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