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Individual

KATHARINE M BERMINGHAM CORDOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
14506 W GRANITE VALLEY DR, #206, SUN CITY WEST, AZ 85375-6010
(623) 584-2127
(623) 584-1257
Mailing address
13943 N 91ST AVE, C-101, PEORIA, AZ 85381-3629
(623) 760-9449
(623) 974-9351

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
46040
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1396962767
BLUE CROSS BLUE SHIELD
AZ
01
3044230
UNITED HEALTHCARE
AZ
01
5Z0069
HEALTH NET
AZ
01
722830
AHCCCS
AZ
05
722830
AZ
01
P01106960
RAILROAD MEDICARE
AZ
Enumeration date
04/19/2007
Last updated
01/26/2016
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