Healthcare Provider Details

I. General information

NPI: 1376505438
Provider Name (Legal Business Name): SUZANNE MARIE DELLARIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE MARIE ST MARTIN MD

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N CAMPBELL AVE DEPT OF
TUCSON AZ
85719-4330
US

IV. Provider business mailing address

200 N FREEMAN RD
TUCSON AZ
85748-8913
US

V. Phone/Fax

Practice location:
  • Phone: 520-626-7221
  • Fax:
Mailing address:
  • Phone: 214-862-4817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number76590
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: