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General NPI Number Information
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NPI Number | 1326681842
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Entity Type | Organization
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Legal Business Name | BRIAN DONOVAN MD CASALIM FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 2902 E GRANT RD
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City | TUCSON
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State | AZ
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Zip | 85716-2742
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Country | US
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Telephone | 941-650-6810
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Fax |
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Provider Business Mailing Address
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Address Line | 2902 E GRANT RD
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City | TUCSON
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State | AZ
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Zip | 85716-2742
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | BRIAN DONOVAN
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Credential | MD
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Telephone | 520-650-6810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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