Individual
ALAN DALE WAMBOLDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7525 E BROADWAY RD, SUITE 3, MESA, AZ 85208-2002
(480) 832-2097
(480) 832-0530
Mailing address
7525 E BROADWAY RD, SUITE 3, MESA, AZ 85208-2002
(480) 832-2097
(480) 832-0530
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17046
AZ
Other
Enumeration date
06/16/2006
Last updated
01/16/2008
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