Organization
MARYVALE FAMILY PRACTICE GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVETIS ORDAKIAN (PRESIDENT)
(623) 209-5555
Entity
Organization
Contact information
Practice address
4700 N 51ST AVE, SUITE 6, PHOENIX, AZ 85031-1237
(623) 209-5555
(623) 247-1905
Mailing address
4700 N 51ST AVE, SUITE 6, PHOENIX, AZ 85031-1237
(623) 209-5555
(623) 247-1905
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
—
AZ
Other
Enumeration date
12/24/2007
Last updated
04/15/2011
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