Individual
DR. EUGENE F. THARALSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
28034
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120390
GROUP MEDICARE NUMBER
AZ
01
—
317047
GROUP MEDICAID NUMBER
AZ
05
—
885413-02
—
AZ
Enumeration date
05/11/2006
Last updated
02/16/2017
Update your record
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