Individual
DR. FELIPE L.G. VIDELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1616 E MARYLAND AVE, PHOENIX, AZ 85016-1302
(602) 788-1521
(602) 688-5420
Mailing address
1616 E MARYLAND AVE, PHOENIX, AZ 85016-1302
(602) 788-1521
(602) 688-5420
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
30207
AZ
207VG0400X
Gynecology Physician
30207
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
709438
—
AZ
01
—
7802344
AETNA
AZ
01
—
AZ0718260
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
08/17/2005
Last updated
02/26/2024
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