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Individual
CORAL A QUIET
Active
Individual
CORAL A QUIET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
21606
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138075
AHCCCS
AZ
05
—
138075
—
AZ
Enumeration date
04/12/2006
Last updated
07/21/2022
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