| Imd Physicians Arizona PLLC | |
|
7250 N 16th St Ste 104 Phoenix AZ 85020-5214 | |
| (602) 714-2815 | |
| Not Available |
| Full Name | Imd Physicians Arizona PLLC |
|---|---|
| Speciality | Emergency Medicine - Emergency Medical Services |
| Location | 7250 N 16th St Ste 104, Phoenix, Arizona |
| Authorized Official Name and Position | Micah D Hale (CEO) |
| Authorized Official Contact | 8318189833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imd Physicians Arizona PLLC 4325 E Glacier Place Phoenix AZ 85029-5653 Ph: (602) 318-7878 | Imd Physicians Arizona PLLC 7250 N 16th St Ste 104 Phoenix AZ 85020-5214 Ph: (602) 714-2815 |
| NPI Number | 1629616727 |
|---|---|
| Provider Enumeration Date | 12/19/2019 |
| Last Update Date | 03/24/2020 |
| Certification Date | 03/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629616727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Secondary |
| 207PE0004X | Emergency Medicine - Emergency Medical Services | (NU) | Primary |
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