Individual
DR. MARY JEAN FIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1255 W WASHINGTON ST, TEMPE, AZ 85281-1210
(602) 685-5211
(602) 685-5028
Mailing address
1255 W WASHINGTON ST, TEMPE, AZ 85281-1210
(602) 685-5211
(602) 685-5325
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
20108
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111287
—
AZ
01
—
1Z7112
HEALTH NET AZ-SUN CITY PA
AZ
01
—
AX4478
HEALTH NET AZ-PATH ASSOC
AZ
01
—
AZ0182900
BCBSAZ-PATH ASSOC
AZ
01
—
AZ0828930
BCBSAZ-SUN CITY PATH
AZ
Enumeration date
02/22/2006
Last updated
03/21/2017
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