Healthcare Provider Details

I. General information

NPI: 1255522082
Provider Name (Legal Business Name): MARC M SOLOMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MARCOS M SOLIMAN MD

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/04/2021
Certification Date: 07/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14445 W MCDOWELL RD STE A104
GOODYEAR AZ
85395-2518
US

IV. Provider business mailing address

14445 W MCDOWELL RD STE A104
GOODYEAR AZ
85395-2518
US

V. Phone/Fax

Practice location:
  • Phone: 480-550-9393
  • Fax: 480-591-0485
Mailing address:
  • Phone: 623-232-8787
  • Fax: 623-232-2789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number43959
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number43959
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: