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Individual

MRS. MARY ANN ANN LECAVALIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10900 N SCOTTSDALE RD., #603, SCOTTSDALE, AZ 85254-5216
(480) 607-3800
(480) 607-3808
Mailing address
10900 N SCOTTSDALE RD., #603, SCOTTSDALE, AZ 85254-5216
(480) 607-3800
(480) 607-3808

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
25063
AZ
207R00000X
Internal Medicine Physician
Primary
25063
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080186441
RAIL ROAD
AZ
05
398059
AZ
01
AZ0729180
BSBSAZ
AZ
Enumeration date
06/16/2005
Last updated
05/17/2011
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