Individual
DR. NICK STAVRIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6644 E BAYWOOD AVE, MESA, AZ 85206
(480) 981-4200
Mailing address
5000 HOPYARD RD, SUITE 100, PLEASANTON, CA 94588-3348
(800) 617-7717
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3565
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3981220
EVERCARE GRP
AZ
01
—
453051001
GROUP HEALTH GRP
AZ
05
—
548646
—
AZ
01
—
860373636
HUMANA GROUP
AZ
01
—
AW1436
HEALTHNET GRP
AZ
01
—
AZ0728670
BLUE CROSS BLUE SHIELD GR
AZ
Enumeration date
11/10/2005
Last updated
09/22/2021
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