Individual
COLIN BOHANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2945 S DOBSON RD, MESA, AZ 85202-7941
(480) 969-4138
Mailing address
2320 N 3RD ST, PHOENIX, AZ 85004-1303
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
69753
AZ
Other
Enumeration date
04/07/2016
Last updated
09/11/2023
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