# SCOTTSDALE INTERNAL MEDICINE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790050409
- **Authorized official:** MR. CHARLES BENJAMIN EVANS II MD (OWNER)
- **Authorized official phone:** (602) 292-0552

## Contact information

- **Practice address:** 4643 N 12TH ST STE 101, PHOENIX, AZ 85014-4083
- **Practice address phone:** (602) 812-3789
- **Mailing address:** 4643 N 12TH ST STE 101, PHOENIX, AZ 85014-4083
- **Mailing address phone:** (602) 812-3789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | NULL | Yes |
| 364SA2200X | Adult Health Clinical Nurse Specialist | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2012
- **Last updated:** 02/29/2024