Individual
DR. RONALD C PETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2653 W GUADALUPE RD, MESA, AZ 85202-7200
(480) 455-1860
(480) 455-1862
Mailing address
2653 W GUADALUPE RD, MESA, AZ 85202-7200
(480) 455-1860
(480) 455-1862
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31540
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470001313
RAILROAD MEDICARE
AZ
05
—
935281
—
AZ
Enumeration date
05/03/2006
Last updated
06/25/2012
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