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Individual

BART L MC RAE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
CARONDELET HOLY CROSS HOSPITAL, 1171 W. TARGET RANGE ROAD, NOGALES, AZ 85621
(520) 287-2771
Mailing address
7425 N MONA LISA RD, APT 59, TUCSON, AZ 85741-4526

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
050410
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
198368-01
AZ
Enumeration date
06/13/2006
Last updated
03/09/2009
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