Organization
MATERNAL FETAL MEDICINE AND GENETICS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN PONKEY M.D. (PHYSICIAN)
(480) 773-7903
Entity
Organization
Contact information
Practice address
1772 E. BOSTON STREET, SUITE 107, GILBERT, AZ 85295-6243
(480) 773-7903
(480) 773-6512
Mailing address
7380 E ALTA SIERRA DR, SCOTTSDALE, AZ 85266-1885
(480) 773-7903
(480) 773-6512
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119406
—
AZ
05
—
826480
—
AZ
Enumeration date
01/25/2016
Last updated
04/23/2017
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