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Individual

ANDREW POULOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15810 S 45TH ST STE 110, PHOENIX, AZ 85048-7695
(480) 763-7273
Mailing address
7416 E PALO VERDE DR, SCOTTSDALE, AZ 85250-6030
(480) 888-6248

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
15512
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171281
AZ
Enumeration date
01/24/2006
Last updated
08/28/2019
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