| Advanced Diabetes And Endocrine Care | |
|
700 S 320th St Suite D Federal Way WA 98003-4691 | |
| (253) 880-1029 | |
| (253) 322-6203 |
| Full Name | Advanced Diabetes And Endocrine Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 700 S 320th St, Federal Way, Washington |
| Authorized Official Name and Position | Shaista A Quddusi (PRESIDENT) |
| Authorized Official Contact | 2538801029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Diabetes And Endocrine Care 700 S 320th St Suite D Federal Way WA 98003-4691 Ph: (253) 880-1029 | Advanced Diabetes And Endocrine Care 700 S 320th St Suite D Federal Way WA 98003-4691 Ph: (253) 880-1029 |
| NPI Number | 1518375880 |
|---|---|
| Provider Enumeration Date | 07/30/2014 |
| Last Update Date | 11/24/2014 |
| Medicare PECOS PAC ID | 2163744012 |
|---|---|
| Medicare Enrollment ID | O20141203000878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518375880 | NPI | - | NPPES |
| P00181501 | Other | WA | RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | MD00032808 (Washington) | Primary |
| Provider Name | Shaista A Quddusi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1053340885 PECOS PAC ID: 0244299881 Enrollment ID: I20041008000069 |
Pacmed Clinics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 31833 Gateway Center Blvd S, Federal Way, WA 98003 Phone: 253-214-1920 | |
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