NPI 1033109863

Havasu Medical Care

Organisation General Practice Physician Lake Havasu City, AZ

Practice location

Address: 1955 McCulloch Blvd N, Lake Havasu City, AZ 86403-5748
Phone: (928) 453-3007
Fax: (928) 680-9663

Authorised official

Name: Mary Lou Callerame
Title: M.D.
Phone: (928) 453-3007

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

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Registry record

NPI: 1033109863
Entity type: Organization
NPI issued: 24 Oct 2005
Record last updated: 18 Nov 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.