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Organization
SUMMIT MEDICAL GROUP (ABDOU & BACCHUS) PC
Active
Organization
SUMMIT MEDICAL GROUP (ABDOU & BACCHUS) PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALISSA THATCHER (CREDENTIALING SPECIALIST)
(702) 932-8547
Entity
Organization
Contact information
Practice address
1776 E WARM SPRINGS RD, 208, LAS VEGAS, NV 89119-4676
(702) 932-8547
(702) 932-8586
Mailing address
525 N 18TH ST, PHOENIX, AZ 85006-4102
(702) 932-8547
(702) 932-8586
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/03/2006
Last updated
08/22/2020
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