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Individual

PETER EBOT OBEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RVT, RDCS,RDMA

Contact information

Practice address
6040 E MAIN ST STE 123, MESA, AZ 85205-8928
(678) 857-0705
Mailing address
6040 E MAIN ST STE 123, MESA, AZ 85205-8928
(678) 857-0705

Taxonomy

Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
70271
AZ
246XS1301X
Sonography Specialist/Technologist Cardiovascular
Primary
70271
AZ
2471S1302X
Sonography Radiologic Technologist
70271
AZ
2471V0105X
Vascular Sonography Radiologic Technologist
70271
AZ

Other

Enumeration date
07/23/2017
Last updated
07/21/2022
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