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 (DIRECTOR, CREDENTIALING)
(602) 470-5519
Entity
Organization
Contact information
Practice address
15182 N 75TH AVE STE 180, PEORIA, AZ 85381-4722
(623) 487-3334
(623) 487-3656
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5519
(602) 470-5064
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208600000X
Surgery Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
475747
—
AZ
Enumeration date
01/02/2020
Last updated
02/19/2020
Update your record
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