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Organization
DISTRICT MEDICAL GROUP, INC
Active
Organization
DISTRICT MEDICAL GROUP, INC
Active
Parent organization
DISTRICT MEDICAL GROUP, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DISTRICT MEDICAL GROUP, INC
Authorized official
TERESA CORDEIRO (CREDENTIALING DIRECTOR)
(602) 470-5000
Entity
Organization
Contact information
Practice address
2601 E ROOSEVELT ST, PATHOLOGY, PHOENIX, AZ 85008-4973
(602) 344-5529
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
NULL
207ZC0500X
Cytopathology Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
NULL
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
207ZP0104X
Chemical Pathology Physician
—
NULL
207ZP0104X
Chemical Pathology Physician
—
—
Other
Enumeration date
09/09/2009
Last updated
10/01/2014
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