Individual
MARIDINE L. CO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6321 VIA SERENA DR, EL PASO, TX 79912-2661
(313) 212-7680
Mailing address
6321 VIA SERENA DR, EL PASO, TX 79912-2661
(313) 212-7680
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
60230
WI
207RG0100X
Gastroenterology Physician
Q8708
TX
208000000X
Pediatrics Physician
4301089612
MI
208000000X
Pediatrics Physician
60230
WI
2080P0206X
Pediatric Gastroenterology Physician
Primary
Q8708
TX
Other
Enumeration date
11/14/2007
Last updated
08/28/2019
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