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Individual

MRS. SHERIDA CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
108 S BROAD ST, GLOBE, AZ 85501-2602
(928) 425-6592
(928) 425-7655
Mailing address
PO BOX 1508, CLAYPOOL, AZ 85532-1508
(928) 402-0952
(928) 425-7566

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1994
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1205962792
MEDCOM MEDICAL, LLC NPI
AZ
05
396558
AZ
01
Z71760
MEDCOM MEDICAL, LLC
AZ
Enumeration date
11/08/2006
Last updated
02/20/2014
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