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Organization
MATERNAL FETAL MEDICINE OF ARIZONA LLC
Active
Organization
MATERNAL FETAL MEDICINE OF ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD ANDREW RUSSELL (CHIEF EXECUTIVE OFFICER)
(480) 399-3880
Entity
Organization
Contact information
Practice address
4852 E BASELINE RD, STE 104, MESA, AZ 85206-4627
(480) 467-3545
(480) 467-3565
Mailing address
8912 E PINNACLE PEAK RD, STE F9-585, SCOTTSDALE, AZ 85255-3659
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
40444
AZ
Other
Enumeration date
12/07/2012
Last updated
01/18/2013
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