Provider Demographics
NPI:1063414860
Name:M&M POWELL INC.
Entity type:Organization
Organization Name:M&M POWELL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO-POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:480-967-6540
Mailing Address - Street 1:PO BOX 27514
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85285-7514
Mailing Address - Country:US
Mailing Address - Phone:480-967-6500
Mailing Address - Fax:480-967-6540
Practice Address - Street 1:7525 E BROADWAY RD
Practice Address - Street 2:STE 8
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-2002
Practice Address - Country:US
Practice Address - Phone:480-967-6500
Practice Address - Fax:480-967-6540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty