Healthcare Provider Details

I. General information

NPI: 1215009162
Provider Name (Legal Business Name): MROZ BAIER BREAST CARE CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6005 PARK AVE #700
MEMPHIS TN
38119-5217
US

IV. Provider business mailing address

6005 PARK AVE #700
MEMPHIS TN
38119-5217
US

V. Phone/Fax

Practice location:
  • Phone: 901-527-3391
  • Fax: 901-578-3969
Mailing address:
  • Phone: 901-527-3391
  • Fax: 901-578-3969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINE MROZ
Title or Position: OWNER, AO
Credential: MD
Phone: 901-527-3391