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Individual

DR. THADDEO CONSUNJI OCONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
612 W BASELINE RD, MESA, AZ 85210-6041
(480) 834-9039
(480) 964-7802
Mailing address
612 W BASELINE RD, MESA, AZ 85210-6041
(480) 834-9039
(480) 964-7802

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
M001478
GU
207RN0300X
Nephrology Physician
Primary
40121
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
354819
AZ
Enumeration date
09/05/2006
Last updated
05/25/2012
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