Gloudemans, Mary
Gloudemans, Mary is an sole proprietor health care provider with primary practice located at 1925 W Orange Grove Rd Ste 302 , Tucson AZ 85704-1152. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gloudemans, Mary can be contacted via phone (520) 797-3888.Contact Information
Primary practice address
1925 W Orange Grove Rd Ste 302
Tucson AZ 85704-1152
Phone: (520) 797-3888
Fax: (520) 797-2196
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 17746 | Arizona |
Profile Details
| NPI number | 1700872454 |
|---|---|
| LBN Legal business name | Gloudemans, Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2005 |
| Last updated | May 27th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700872454 | NPPES |
| Arizona | MEDICAID | 276651 |
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