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Individual

DR. ELLISON F HERRO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5115 N CENTRAL AVE, PHOENIX, AZ 85012-1478
(602) 264-1818
(602) 264-2172
Mailing address
5133 N CENTRAL AVE, SUITE 200, PHOENIX, AZ 85012-1438
(602) 264-8015
(602) 264-2172

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
213257
AZ
Enumeration date
10/21/2005
Last updated
07/08/2007
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