MEDICARE: DR. RON B SCHIFMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZM0300X	Medical Microbiology Physician	12382	AZ
2	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	12382	AZ

General Provider Information

NPI Number	:	1194753988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RON B SCHIFMAN MD

Provider Business Mailing Address
First Line	:	12230 E MAKOHOH TRL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-8684
Country	:	US
Telephone Number	:	520-749-4763
Fax Number	:	520-629-1756

Provider Business Practice Location Address
First Line	:	3601 S 6TH AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85723-0001
Country	:	US
Telephone Number	:	520-629-4629
Fax Number	:	520-629-1756

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	08/08/2019

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