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Individual

BONTE GBEMUDU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
13471 W CORNERSTONE BLVD, GOODYEAR, AZ 85395-2713
(877) 809-5092
(623) 213-8808
Mailing address
3033 N CENTRAL AVE STE 145, PHOENIX, AZ 85012-2808
(877) 809-5092

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54480
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
298755
AZ
Enumeration date
06/23/2010
Last updated
06/03/2019
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