Provider Demographics
NPI:1003084682
Name:POTTGEN, SHERRY PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:PATRICIA
Last Name:POTTGEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10498 E MORNING STAR DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-8658
Mailing Address - Country:US
Mailing Address - Phone:480-350-7853
Mailing Address - Fax:
Practice Address - Street 1:21807 N SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7439
Practice Address - Country:US
Practice Address - Phone:480-425-8488
Practice Address - Fax:480-425-8498
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ38003208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics