Healthcare Provider Details

I. General information

NPI: 1427088350
Provider Name (Legal Business Name): MARC A OLIVIER M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W CAMINO CASA VERDE
GREEN VALLEY AZ
85614-3564
US

IV. Provider business mailing address

2149 E WARNER RD SUITE 101
TEMPE AZ
85284-3494
US

V. Phone/Fax

Practice location:
  • Phone: 520-623-2642
  • Fax: 520-623-6162
Mailing address:
  • Phone: 480-610-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number36920
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA84518
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: