Individual
DR. MIRELA PONDUCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 249-0212
Mailing address
PO BOX 843763, DALLAS, TX 75284-3763
(469) 505-1666
(469) 436-3937
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036122646
IL
207R00000X
Internal Medicine Physician
036.122646
IL
208M00000X
Hospitalist Physician
Primary
42568
AZ
390200000X
Student in an Organized Health Care Education/Training Program
125-052075
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036122646-1
—
IL
05
—
525097
—
AZ
Enumeration date
10/28/2008
Last updated
10/19/2023
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