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1134861248
AGNES J PREMKUMAR
PHOENIX, AZ
NPI
1134861248
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: 390200000X)
Enumeration Date
2022-04-09
Last Update Date
2022-04-09
Business Address
AGNES J PREMKUMAR MD
2601 E ROOSEVELT ST
PHOENIX, AZ 85008-4973
Phone number: 602-344-5011
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Mailing Address
AGNES J PREMKUMAR MD
4001 N 3RD ST STE 290
PHOENIX, AZ 85012-2071
Phone number:
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