Healthcare Provider Details

I. General information

NPI: 1376585166
Provider Name (Legal Business Name): PATTERSON SCHLOTTERER MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 480-759-1040
  • Fax: 480-759-3520
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: MS. MARY E SCHLOTTERER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 602-257-9229