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General NPI Number Information
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NPI Number | 1053872622
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Entity Type | Individual
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Provider Name | MARA DUBNOW
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Gender | Female
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 4747 N 7TH ST STE 150
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City | PHOENIX
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State | AZ
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Zip | 85014-3677
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Country | US
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Telephone | 602-240-2401
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Fax | 602-792-0244
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Provider Business Mailing Address
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Address Line | PO BOX 748860
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City | ATLANTA
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State | GA
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Zip | 30374-8860
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Country | US
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Telephone | 602-240-2401
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 66170
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License Number State | AZ
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