Individual
WINA PORIESCHA YOUSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
617 N HUMPHREYS ST STE 102, FLAGSTAFF, AZ 86001-3063
(480) 610-6100
Mailing address
2610 N 3RD ST, PHOENIX, AZ 85004-1102
(480) 610-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
60584
AZ
Other
Enumeration date
05/29/2016
Last updated
09/17/2021
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