Provider Demographics
NPI:1992765846
Name:SCHLOTTERER, MARY E (MD)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:E
Last Name:SCHLOTTERER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:E
Other - Last Name:SCHLOTTERER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:515 W BUCKEYE RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-2647
Mailing Address - Country:US
Mailing Address - Phone:602-254-2727
Mailing Address - Fax:602-258-3901
Practice Address - Street 1:515 W BUCKEYE RD
Practice Address - Street 2:SUITE 404
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003
Practice Address - Country:US
Practice Address - Phone:602-254-2727
Practice Address - Fax:602-258-3901
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21607207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ141995Medicaid
AZE93377Medicare UPIN