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General NPI Number Information
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NPI Number | 1114991171
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Entity Type | Individual
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Provider Name | DEANNA LYNN BULLARO-ANDERER DO
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Gender | Female
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 5304 E SOUTHERN AVE STE 110
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City | MESA
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State | AZ
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Zip | 85206-3623
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Country | US
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Telephone | 480-237-3040
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Fax | 480-237-3049
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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 | 480-237-3040
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Fax | 480-237-3049
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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 | 3271
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License Number State | AZ
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