Healthcare Provider Details

I. General information

NPI: 1972676344
Provider Name (Legal Business Name): MANJU D SCHORR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MANJU D SUD M.D.

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 08/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 W 24TH ST SUITE 202
YUMA AZ
85364-6370
US

IV. Provider business mailing address

1501 W 24TH ST SUITE 202
YUMA AZ
85364-6370
US

V. Phone/Fax

Practice location:
  • Phone: 602-249-2490
  • Fax: 602-249-2555
Mailing address:
  • Phone: 602-249-2490
  • Fax: 602-249-2555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number31316
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: