Provider Demographics
NPI:1487882049
Name:HARREL, MARY CATHERINE (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:HARREL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:CATHERINE
Other - Last Name:LAWLESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1925 W ORANGE GROVE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1151
Mailing Address - Country:US
Mailing Address - Phone:520-372-2167
Mailing Address - Fax:
Practice Address - Street 1:1925 W ORANGE GROVE RD STE 201
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1151
Practice Address - Country:US
Practice Address - Phone:520-372-2167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49774207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine