Individual
MICHAEL WASMUNDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1301 S CRISMON RD, MESA, AZ 85209-3767
(480) 358-6100
Mailing address
6052 W IRMA LN, GLENDALE, AZ 85308-6749
(480) 560-9648
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4746
AZ
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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