Organization
ADAMANTIUM INK P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN L MARASIGAN M.D. (PRESIDENT AND DIRECTOR)
(713) 791-4931
Entity
Organization
Contact information
Practice address
3954 E WALLER LN, PHOENIX, AZ 85050-4916
(713) 791-4931
Mailing address
8424 E SHEA BLVD STE 101, SCOTTSDALE, AZ 85260-6662
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD47798
AZ
310400000X
Assisted Living Facility
MD47798
AZ
Other
Enumeration date
06/17/2014
Last updated
07/28/2016
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