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CHETHAN RAM MUDIYAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
(602) 521-5700
(602) 521-5701
Mailing address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 839-3827
(602) 839-2359

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R77674
AZ

Other

Enumeration date
06/28/2018
Last updated
09/04/2019
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