Individual
SYAMALA V DARIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1003 WILLOW CREEK ROAD, PRESCOTT, AZ 86301
(928) 771-5487
(928) 771-5471
Mailing address
PO BOX 11720, PRESCOTT, AZ 86301
(928) 771-5487
(908) 771-5471
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37414
CO
207R00000X
Internal Medicine Physician
Primary
AZ40118
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332525
—
AZ
05
—
93322534
—
CO
Enumeration date
09/22/2006
Last updated
09/15/2011
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