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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 (CREDENTIALING DIRECTOR)
(602) 470-5000
Entity
Organization

Contact information

Practice address
2601 E ROOSEVELT ST, EMERGENCY MEDICINE, PHOENIX, AZ 85008-4973
(602) 470-5011
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
207PT0002X
Medical Toxicology (Emergency Medicine) Physician

Other

Enumeration date
10/16/2014
Last updated
10/16/2014
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