Individual
MARIAH CHOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9059 W. LAKE PLEASANT PKWY, STE E-540, PEORIA, AZ 85382
(623) 322-3380
(623) 322-4399
Mailing address
9059 W. LAKE PLEASANT PKWY, STE E-540, PEORIA, AZ 85382
(623) 322-3380
(623) 322-4399
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
320080797
SURPRISE PEDIATRICS
AZ
Enumeration date
04/05/2019
Last updated
09/15/2021
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