| Associated Desert Gastroenterologists Pc | |
|
215 S Power Rd # 102 Mesa AZ 85206-5235 | |
| (480) 985-9005 | |
| (480) 396-9974 |
| Full Name | Associated Desert Gastroenterologists Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 215 S Power Rd, Mesa, Arizona |
| Authorized Official Name and Position | Prem C Kumar (OWNER) |
| Authorized Official Contact | 4809859005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Associated Desert Gastroenterologists Pc 215 S Power Rd Suite 102 Mesa AZ 85206-5235 Ph: (480) 985-9005 | Associated Desert Gastroenterologists Pc 215 S Power Rd # 102 Mesa AZ 85206-5235 Ph: (480) 985-9005 |
| NPI Number | 1336320613 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 11/04/2014 |
| Medicare PECOS PAC ID | 9133103658 |
|---|---|
| Medicare Enrollment ID | O20040614001162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336320613 | NPI | - | NPPES |
| 0002430 | Other | AZ | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 12854 (Arizona) | Primary |
| Provider Name | Prem C Kumar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700841350 PECOS PAC ID: 7618951914 Enrollment ID: I20050317000375 |
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