Organization
PHOENIX INFECTIOUS DISEASES CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NDIDIAMAKA U OBIESIE MD (OWNER/ PRESIDENT)
(602) 790-4108
Entity
Organization
Contact information
Practice address
3330 N 2ND ST STE 401, PHOENIX, AZ 85012-2371
(602) 254-1136
(602) 279-1720
Mailing address
530 E MCDOWELL RD STE 107-609, PHOENIX, AZ 85004-1549
(602) 790-4108
(623) 218-9209
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
30584
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71505
MEDICARE UNSPEC
—
05
—
763062
—
AZ
Enumeration date
05/06/2008
Last updated
12/02/2014
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