Individual
DR. MARK SCHLOTTERBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
652 E WARNER RD, SUITE 107, GILBERT, AZ 85296-3071
(480) 539-8680
(480) 539-1763
Mailing address
652 E WARNER RD, SUITE 107, GILBERT, AZ 85296-3071
(480) 539-8680
(480) 539-1763
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25461
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z68207
PTAN
AZ
Enumeration date
05/27/2006
Last updated
06/30/2014
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