Individual provider · Type 1 NPI
Matthew Pettengill, DPM
Foot & Ankle Surgery Podiatrist · Phoenix, AZ
NPI number
1215046974
Active
Practice location
4212 N 16th St
Phoenix, AZ 85016-5319
Fax (602) 200-5383
Mailing address
PO Box 31001-0698
Pasadena, CA 91110-0698
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | POD1049 (ME) |
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | SC004785L (PA) |
Foot & Ankle Surgery Podiatrist: Definition to come...
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Other foot & ankle surgery podiatrist providers in Phoenix
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About NPI 1215046974
Matthew Pettengill, DPM's National Provider Identifier is 1215046974, issued on Aug 29, 2006. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Phoenix, AZ. The record was last updated on Jul 29, 2011.