District Medical Group, INC

NPI #1619200722 in Phoenix, Arizona

Provider Information

NPI Number: 1619200722
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: Oct 1, 2014

Practice Location

Address: 2525 E ROOSEVELT ST
Address 2: SURGERY CLINIC
City: Phoenix
State: Arizona
ZIP Code: 85008-4948
Phone: (602) 344-5146

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery - Surgical Critical Care — Surgical Critical Care	2086S0102X
Surgery - Surgery of the Hand — Surgery of the Hand	2086S0105X
Surgery - Pediatric Surgery — Pediatric Surgery	2086S0120X
Surgery - Plastic and Reconstructive Surgery — Plastic and Reconstructive Surgery	2086S0122X
Surgery - Trauma Surgery — Trauma Surgery	2086S0127X
Surgery - Surgical Oncology — Surgical Oncology	2086X0206X
Urology	208800000X
Thoracic Surgery (Cardiothoracic Vascular Surgery)	208G00000X
Surgery	208600000X	Primary

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