Provider Demographics
NPI:1316928153
Name:NOWLIN, MARY CATHERINE (DO)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:NOWLIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7155 W CAMPO BELLO DR STE C120
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8594
Mailing Address - Country:US
Mailing Address - Phone:623-322-7301
Mailing Address - Fax:623-337-9562
Practice Address - Street 1:7155 W CAMPO BELLO DR STE C120
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8594
Practice Address - Country:US
Practice Address - Phone:623-322-7301
Practice Address - Fax:623-337-9562
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ35142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F04022Medicare UPIN