Organization
APP MATERNAL FETAL MEDICINE
Active
Parent organization
ASANTE PHYSICIAN PARTNERS
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASANTE PHYSICIAN PARTNERS
Authorized official
SHERI BODAGER (VP EXECTIVE DIRECTOR)
(541) 789-4129
Entity
Organization
Contact information
Practice address
2911 SISKIYOU BLVD, MEDFORD, OR 97504-8179
(541) 789-5982
Mailing address
PO BOX 748157, LOS ANGELES, CA 90074-8157
(541) 789-5250
(541) 789-5538
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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