Casalim Family Medicine | |
2902 E Grant Rd Tucson AZ 85716-2742 | |
(941) 650-6810 | |
Not Available |
Full Name | Casalim Family Medicine |
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Speciality | Family Medicine |
Location | 2902 E Grant Rd, Tucson, Arizona |
Authorized Official Name and Position | Brian Donovan (PROVIDER) |
Authorized Official Contact | 5206506810 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Casalim Family Medicine 2902 E Grant Rd Tucson AZ 85716-2742 Ph: () - | Casalim Family Medicine 2902 E Grant Rd Tucson AZ 85716-2742 Ph: (941) 650-6810 |
NPI Number | 1326681842 |
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Provider Enumeration Date | 10/28/2019 |
Last Update Date | 03/18/2020 |
Medicare PECOS PAC ID | 0547698912 |
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Medicare Enrollment ID | O20200318000296 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326681842 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Brian Shannon Donovan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780686949 PECOS PAC ID: 8123094745 Enrollment ID: I20171114003105 |
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