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General NPI Number Information
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NPI Number | 1578686754
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Entity Type | Individual
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Provider Name | TERESA M AYELA-UWANGUE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 3530 S VAL VISTA DR STE A111
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City | GILBERT
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State | AZ
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Zip | 85297-7319
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Country | US
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Telephone | 480-670-2400
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Fax | 480-870-2019
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Provider Business Mailing Address
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Address Line | 2310 W MULBERRY DR
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City | CHANDLER
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State | AZ
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Zip | 85286-6738
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Country | US
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Telephone | 585-967-2341
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 42902
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 42902
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MT189001
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License Number State | PA
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