Individual
DR. MARY CATHERINE PORVAZNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1501 S YALE ST STE 2, FLAGSTAFF, AZ 86001-7304
(928) 527-4325
(928) 527-4327
Mailing address
1501 S YALE ST STE 2, FLAGSTAFF, AZ 86001-7304
(928) 527-4325
(928) 527-4327
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22035
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
434853
—
AZ
05
—
50553771
—
CO
05
—
Z3755
—
NM
Enumeration date
10/14/2005
Last updated
09/28/2023
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