Individual
MONICA R VANDIVORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
599 E WILCOX DR, SIERRA VISTA, AZ 85635-2531
(520) 459-4604
(520) 458-2444
Mailing address
599 E WILCOX DR, SIERRA VISTA, AZ 85635-2531
(520) 459-4604
(520) 459-4603
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
26972
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
445230
—
AZ
Enumeration date
04/22/2006
Last updated
04/15/2024
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