Healthcare Provider Details

I. General information

NPI: 1891909800
Provider Name (Legal Business Name): DARCEY MARIANNA WINTERLAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARCEY MARIANA WINTERLAND MARTIN

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 S MCCLINTOCK DR STE 101
TEMPE AZ
85283-3393
US

IV. Provider business mailing address

6301 S MCCLINTOCK DR STE 101
TEMPE AZ
85283-3393
US

V. Phone/Fax

Practice location:
  • Phone: 480-831-6800
  • Fax:
Mailing address:
  • Phone: 480-831-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36800
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: