District Medical Group, INC

NPI #1174856280 in Phoenix, Arizona

Provider Information

NPI Number: 1174856280
Entity Type: Organization
Organization Name: District Medical Group, INC
Subpart: Yes (part of a larger organization)
Parent Organization: DISTRICT MEDICAL GROUP, INC
Primary Specialty: Surgery
Enumeration Date: Sep 9, 2009
Last Updated: Jun 22, 2017

Practice Location

Address: 2525 E ROOSEVELT ST
Address 2: MED CLINIC - INFECTIOUS DISEASE
City: Phoenix
State: Arizona
ZIP Code: 85008-4948
Phone: (602) 344-1095

Authorized Official

Name: TERESA CORDEIRO
Title: CREDENTIALING DIRECTOR
Phone: (602) 470-5000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dental Hygienist	124Q00000X
Anesthesiology	207L00000X
Family Medicine	207Q00000X
Internal Medicine	207R00000X
Internal Medicine - Infectious Disease — Infectious Disease	207RI0200X
Obstetrics & Gynecology	207V00000X
Orthopaedic Surgery	207X00000X
Pathology - Anatomic Pathology & Clinical Pathology — Anatomic Pathology & Clinical Pathology	207ZP0102X
Pediatrics	208000000X
Psychiatry & Neurology - Psychiatry — Psychiatry	2084P0800X
Radiology - Diagnostic Radiology — Diagnostic Radiology	2085R0202X
Surgery	208600000X	Primary

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