| Pv Mountain Medical Pllc | |
|
1728 W Glendale Ave Ste 204 Phoenix AZ 85021-8863 | |
| (623) 522-4935 | |
| (623) 522-4937 |
| Full Name | Pv Mountain Medical Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1728 W Glendale Ave Ste 204, Phoenix, Arizona |
| Authorized Official Name and Position | Junaid I Qureshi (OWNER) |
| Authorized Official Contact | 4806871280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pv Mountain Medical Pllc 4531 N 16th St Ste 114 Phoenix AZ 85016-5344 Ph: (480) 839-3313 | Pv Mountain Medical Pllc 1728 W Glendale Ave Ste 204 Phoenix AZ 85021-8863 Ph: (623) 522-4935 |
| NPI Number | 1649733981 |
|---|---|
| Provider Enumeration Date | 04/12/2019 |
| Last Update Date | 01/26/2023 |
| Medicare PECOS PAC ID | 7517397185 |
|---|---|
| Medicare Enrollment ID | O20200422001425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649733981 | NPI | - | NPPES |
| Z242652 | Other | AZ | PTAN |
| 506223 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Junaid I Qureshi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1235186628 PECOS PAC ID: 5597793117 Enrollment ID: I20050803000693 |
| Provider Name | Cheryl L Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609330646 PECOS PAC ID: 9133530678 Enrollment ID: I20201204001171 |
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