Organization
CHILDRENS MEDICAL CENTER OF BULLHEAD CITY, PLLC
Active
Other names
PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
NAILA ASHRAF TARIQ M.D. (PHYSICIAN)
(928) 758-0183
Entity
Organization
Contact information
Practice address
1225 HANCOCK RD, SUITE # B, BULLHEAD CITY, AZ 86442-5948
(928) 758-0183
(928) 758-6665
Mailing address
1225 HANCOCK RD, SUITE # B, BULLHEAD CITY, AZ 86442-5948
(928) 758-0183
(928) 758-6665
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31594
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
788531
—
AZ
Enumeration date
09/20/2006
Last updated
11/04/2013
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