| Endocrinology, Diabetes And Longevity Center Of Arizona, Plc. | |
|
7344 E Deer Valley Rd Ste 100 Scottsdale AZ 85255-7456 | |
| (480) 513-1042 | |
| (480) 513-1043 |
| Full Name | Endocrinology, Diabetes And Longevity Center Of Arizona, Plc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 7344 E Deer Valley Rd Ste 100, Scottsdale, Arizona |
| Authorized Official Name and Position | Regina Ford (PRACTICE MANAGER) |
| Authorized Official Contact | 4805131042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endocrinology, Diabetes And Longevity Center Of Arizona, Plc. Po Box 27973 Scottsdale AZ 85255-0149 Ph: () - | Endocrinology, Diabetes And Longevity Center Of Arizona, Plc. 7344 E Deer Valley Rd Ste 100 Scottsdale AZ 85255-7456 Ph: (480) 513-1042 |
| NPI Number | 1154804243 |
|---|---|
| Provider Enumeration Date | 09/13/2018 |
| Last Update Date | 09/10/2021 |
| Medicare PECOS PAC ID | 8820332836 |
|---|---|
| Medicare Enrollment ID | O20181203000921 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154804243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Chioma N Iweha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356321392 PECOS PAC ID: 9638160898 Enrollment ID: I20040519000194 |
| Provider Name | Christy Renee Kutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699927822 PECOS PAC ID: 3072657071 Enrollment ID: I20100215000111 |
| Provider Name | Yasmin Akhunji |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1790918738 PECOS PAC ID: 9335393180 Enrollment ID: I20130204000306 |
| Provider Name | Leeanna Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669821112 PECOS PAC ID: 8325395973 Enrollment ID: I20180727001526 |
| Provider Name | Darrelan Michelle Mcbride |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881323459 PECOS PAC ID: 9335529296 Enrollment ID: I20220708003081 |
| Provider Name | Sharon Nichelle Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033837786 PECOS PAC ID: 6002284296 Enrollment ID: I20221118001609 |
| Provider Name | Liliana Kettenburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548970817 PECOS PAC ID: 2264897545 Enrollment ID: I20230421000655 |
| Provider Name | Meagan Maureen Gruwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386429934 PECOS PAC ID: 4385092865 Enrollment ID: I20231121003357 |
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