Organization
ARIZONA SKIN AND DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANNTEJ SRA M.D. (OWNER)
(623) 815-8200
Entity
Organization
Contact information
Practice address
10249 W THUNDERBIRD BLVD, SUIT 100, SUN CITY, AZ 85351-3113
(623) 815-8200
(623) 344-5458
Mailing address
PO BOX 5002, PEORIA, AZ 85385-5002
(623) 815-8200
(623) 344-5458
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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