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Individual

POONEH SAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
839 W CONGRESS ST, TUCSON, AZ 85745-2819
(520) 670-3909
(520) 309-2560
Mailing address
839 W CONGRESS ST, TUCSON, AZ 85745-2819
(520) 670-3909
(520) 290-5551

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
42165
AZ
208M00000X
Hospitalist Physician
Primary
42165
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
448302
AZ
Enumeration date
04/07/2008
Last updated
05/06/2022
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