Healthcare Provider Details

I. General information

NPI: 1366488686
Provider Name (Legal Business Name): STEVEN MARON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 04/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 S CAMPBELL AVE BUILDING 1
GREEN VALLEY AZ
85614-0503
US

IV. Provider business mailing address

1260 S CAMPBELL AVE BUILDING 2
GREEN VALLEY AZ
85614-0503
US

V. Phone/Fax

Practice location:
  • Phone: 520-407-5800
  • Fax: 520-407-5990
Mailing address:
  • Phone: 520-407-5600
  • Fax: 520-407-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36692
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA045819
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD035364F
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: