Individual
LYDIA EHLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4616 N 51ST AVE, PHOENIX, AZ 85031-1721
(623) 247-6266
(623) 247-9742
Mailing address
2702 N 3RD ST, PHOENIX, AZ 85004-4608
(602) 323-3407
(602) 323-3496
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
29643
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
871261
—
AZ
Enumeration date
03/24/2006
Last updated
08/18/2016
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