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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