Individual
DR. MIRIAM GUREVICH GEOFFROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
677 N WILMOT RD, TUCSON, AZ 85711-2701
(520) 795-2889
(520) 795-6321
Mailing address
700 E MOREHEAD ST STE 300, CHARLOTTE, NC 28202-2742
(520) 795-2889
(520) 795-6321
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
46717
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
46717
AZ
2085U0001X
Diagnostic Ultrasound Physician
46717
AZ
390200000X
Student in an Organized Health Care Education/Training Program
R72874
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005472
GROUP MEDICAID ID NUMBER
AZ
01
—
1841261989
GROUP NPI
AZ
05
—
254299
—
AZ
Enumeration date
07/17/2011
Last updated
03/07/2024
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