Organization
MOUNTAINSIDE SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DEMAR M.D. (MANAGING PARTNER)
(928) 639-0909
Entity
Organization
Contact information
Practice address
450 S WILLARD ST, STE 107, COTTONWOOD, AZ 86326-2564
(928) 639-0909
Mailing address
PO BOX 3850, COTTONWOOD, AZ 86326-2607
(928) 634-0665
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
07/23/2006
Last updated
11/07/2007
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