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NPI Code Detail

MEDICARE: DR. MARY MEGAN MRDUTT MD

MEDICARE: DR. MARY MEGAN MRDUTT 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
12086X0206XSurgical Oncology Physician78596AZ
2208600000XSurgery Physician70030MN

General Provider Information

NPI Number : 1871938225
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY MEGAN MRDUTT MD
Provider Business Mailing Address
First Line : PO BOX 860912
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55486-0912
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13400 E SHEA BLVD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85259-5499
Country : US
Telephone Number : 480-301-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2013
Last Update Date : 04/06/2026

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