MEDICARE: DR. OMAR MARAR M.D.

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	208600000X	Surgery Physician	MT202922	PA
2	208600000X	Surgery Physician	4301113819	MI
3	208C00000X	Colon & Rectal Surgery Physician	4301113819	MI

General Provider Information

NPI Number	:	1912252321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OMAR MARAR M.D.

Provider Business Mailing Address
First Line	:	4022 E GREENWAY RD STE 11-195
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-4797
Country	:	US
Telephone Number	:	480-896-9888
Fax Number	:	602-953-5466

Provider Business Practice Location Address
First Line	:	6036 N 19TH AVE STE 208
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2104
Country	:	US
Telephone Number	:	480-896-9888
Fax Number	:	602-953-5466

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

Provider Enumeration Date	:	07/23/2012
Last Update Date	:	04/07/2026

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