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Individual

DR. DORIS MARILU CHAVEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1436 WILLIAMSBRIDGE RD, BRONX, NY 10461-2507
(646) 759-5453
(646) 374-4940
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
279186-1
NY
207Q00000X
Family Medicine Physician
35.140675
OH
207Q00000X
Family Medicine Physician
58349
AZ
207Q00000X
Family Medicine Physician
812
FL
207Q00000X
Family Medicine Physician
MD2011-0563
NM
207Q00000X
Family Medicine Physician
S7405
TX

Other

Enumeration date
07/11/2008
Last updated
10/21/2020
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