Individual
BIRCH MARCEL DEGOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 779-3366
Mailing address
1860 AX HANDLE WAY, FLAGSTAFF, AZ 86001-2857
(520) 270-8139
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
49071
AZ
207R00000X
Internal Medicine Physician
R72622
AZ
Other
Enumeration date
05/05/2011
Last updated
09/08/2020
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