Individual provider · Type 1 NPI

Mara Danielle Immediato, PA-C

Surgical Physician Assistant · Tempe, AZ

NPI number 1538410071 Active

Practice location

1255 W Rio Salado Pkwy Ste 107
Tempe, AZ 85281-2892

Fax (480) 962-0590

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X5195 (AZ)

Surgical Physician Assistant: Definition to come...

10 other providers at this address

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About NPI 1538410071

Mara Danielle Immediato, PA-C's National Provider Identifier is 1538410071, issued on Sep 24, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Tempe, AZ. The record was last updated on Feb 4, 2019.