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Contact Information

BLUE WATER INTERNAL MEDICINE ASSOCIATES P C
5263 S HIGHWAY 95
SUITE 101
FORT MOHAVE, AZ86426-9223
 Phone: 928-453-8100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Bone Densitometry Radiologic Technologist

2471B0102X
Indicates primary specialty

NPI Profile & details for BLUE WATER INTERNAL MEDICINE ASSOCIATES P C · (Female)

NPI Number 1801124656
Status Active
Credentials
Entity Individual
Enumeration date 12/04/2009
Last updated 06/18/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • AZ License # 25652
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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