Healthcare Provider Details

I. General information

NPI: 1063667095
Provider Name (Legal Business Name): ARMADILLO PEDIATRICS PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 W BUCKEYE RD STE 402
PHOENIX AZ
85003-2647
US

IV. Provider business mailing address

4530 E RAY RD STE 178
PHOENIX AZ
85044-6094
US

V. Phone/Fax

Practice location:
  • Phone: 602-257-9229
  • Fax: 602-938-9368
Mailing address:
  • Phone: 602-257-9229
  • Fax: 602-257-9368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MARY SCHLOTTERER-PATERSON
Title or Position: MEMBER
Credential: MD
Phone: 602-257-9229