Individual
DR. SARADA SOUMYA PANCHANATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5404
(602) 344-5859
Mailing address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5404
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25765
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
439762
—
AZ
Enumeration date
08/31/2006
Last updated
11/14/2011
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