Individual
MARISA LOUISE HADDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
3201 W PEORIA AVE, STE B307, PHOENIX, AZ 85029-4608
(602) 938-8400
(602) 938-8401
Mailing address
PO BOX 8837, SURPRISE, AZ 85374-0130
(602) 938-8400
(602) 938-8401
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0473
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
398322
—
AZ
Enumeration date
09/13/2005
Last updated
08/07/2013
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