Individual
PETER JAMES DEBARTOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5411
Mailing address
600 S DOBSON RD UNIT 103, MESA, AZ 85202-1818
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
XXXXXXXX
AZ
Other
Enumeration date
05/24/2010
Last updated
12/06/2013
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