| Azmobilemd | |
|
39506 N Daisy Mountain Dr Ste 122-627 Anthem AZ 85086-6084 | |
| (623) 218-4171 | |
| (623) 321-1917 |
| Full Name | Azmobilemd |
|---|---|
| Speciality | Internal Medicine |
| Location | 39506 N Daisy Mountain Dr Ste 122-627, Anthem, Arizona |
| Authorized Official Name and Position | Sam Ile (CEO) |
| Authorized Official Contact | 6232184171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Azmobilemd 39506 N Daisy Mountain Dr Ste 122-627 Anthem AZ 85086-6084 Ph: (623) 218-4171 | Azmobilemd 39506 N Daisy Mountain Dr Ste 122-627 Anthem AZ 85086-6084 Ph: (623) 218-4171 |
| NPI Number | 1689126971 |
|---|---|
| Provider Enumeration Date | 11/02/2016 |
| Last Update Date | 05/06/2022 |
| Medicare PECOS PAC ID | 5496035024 |
|---|---|
| Medicare Enrollment ID | O20161216001485 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689126971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 42672 (Arizona) | Primary |
| Provider Name | Patrick Salvatore Sciara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003866278 PECOS PAC ID: 5092796136 Enrollment ID: I20040526000050 |
| Provider Name | Ryan T Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558358994 PECOS PAC ID: 0648206920 Enrollment ID: I20050830000674 |
| Provider Name | Mary Ann Migaud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407126907 PECOS PAC ID: 6507021326 Enrollment ID: I20120629000172 |
| Provider Name | Jana M Hower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982132775 PECOS PAC ID: 3971873548 Enrollment ID: I20170714001936 |
| Provider Name | Krystle M Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184185282 PECOS PAC ID: 7113260076 Enrollment ID: I20210712003407 |
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