Ponduchi, Mirela
Ponduchi, Mirela is an sole proprietor health care provider with primary practice located at 2000 W Bethany Home Rd , Phoenix AZ 85015-2443. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Ponduchi, Mirela can be contacted via phone (602) 249-0212.Contact Information
Primary practice address
2000 W Bethany Home Rd
Phoenix AZ 85015-2443
Phone: (602) 249-0212
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036122646 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036.122646 | Illinois |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 125-052075 | Illinois |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 42568 | Arizona |
Profile Details
| NPI number | 1902059652 |
|---|---|
| LBN Legal business name | Ponduchi, Mirela |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 28th, 2008 |
| Last updated | Oct 19th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902059652 | NPPES |
| Arizona | MEDICAID | 525097 | |
| Arizona | MEDICAID | 036122646-1 |
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