# APP MATERNAL FETAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ASANTE PHYSICIAN PARTNERS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1538402003
- **Legal business name:** ASANTE PHYSICIAN PARTNERS
- **Authorized official:** SHERI BODAGER (VP EXECTIVE DIRECTOR)
- **Authorized official phone:** (541) 789-4129

## Contact information

- **Practice address:** 2911 SISKIYOU BLVD, MEDFORD, OR 97504-8179
- **Practice address phone:** (541) 789-5982
- **Mailing address:** PO BOX 748157, LOS ANGELES, CA 90074-8157
- **Mailing address phone:** (541) 789-5250
- **Mailing address fax:** (541) 789-5538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/02/2013
- **Last updated:** 04/02/2013