Organization
PEORIA PHYSICIAN GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMIAH FABER (CEO)
(480) 258-3635
Entity
Organization
Contact information
Practice address
13760 N 93RD AVE STE 105, PEORIA, AZ 85381-4260
(480) 809-6589
Mailing address
PO BOX 964, GILBERT, AZ 85299-0964
(480) 366-4489
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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