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General NPI Number Information
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NPI Number | 1891150868
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Entity Type | Organization
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Legal Business Name | SCHLOTTERER GYNECOLOGY LLC
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Dates
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Enumeration Date | 12/17/2015
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 515 W BUCKEYE RD SUITE # 402
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City | PHOENIX
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State | AZ
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Zip | 85003-2647
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Country | US
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Telephone | 480-710-6936
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Fax | 602-257-9368
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Provider Business Mailing Address
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Address Line | 515 W BUCKEYE RD SUITE # 402
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City | PHOENIX
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State | AZ
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Zip | 85003-2647
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Country | US
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Telephone | 480-710-6936
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Fax | 602-257-9368
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY ELIZABETH SCHLOTTERER
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Credential | M.D.
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Telephone | 480-710-6936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 21607
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License Number State | AZ
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