Organization Name: | DISTRICT MEDICAL GROUP, INC |
NPI Number: | 1568795532 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERESA CORDEIRO (CREDENTIALING DIRECTOR) |
Mailing Address: | 2601 E Roosevelt St Radiology Phoenix |
State: | AZ US |
Postal Code: | 850084973 |
Phone Number: | 6023445000 |
Fax Number: | |
NPI Enumeration Date: | 09/09/2009 |
NPI Last Update Date: | 10/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |