Individual
IDA LOURDES MAZZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
711 N SIOUX POINT RD, NORTH SIOUX CITY, SD 57049-5099
(712) 294-7468
Mailing address
711 N SIOUX POINT RD, NORTH SIOUX CITY, SD 57049-5099
(712) 294-7468
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
MD419073
PA
207RC0000X
Cardiovascular Disease Physician
ME133355
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019560820003
—
PA
Enumeration date
09/22/2005
Last updated
01/29/2024
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