Organization
ADVANCED MINIMALLY INVASIVE SURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIUP ALEX KIM MD (MANAGER)
(480) 299-7654
Entity
Organization
Contact information
Practice address
202 E EARLL DR STE 360, PHOENIX, AZ 85012-2677
(480) 788-5621
(480) 779-1277
Mailing address
202 E EARLL DR STE 360, PHOENIX, AZ 85012-2677
(480) 788-5621
(480) 779-1277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207QB0002X
Obesity Medicine (Family Medicine) Physician
—
—
208600000X
Surgery Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501341
—
AZ
01
—
P00924643
RR PTAN
—
01
—
Z139139
PTAN
AZ
01
—
Z139140
MEDICARE PTAN
—
Enumeration date
06/16/2010
Last updated
10/18/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us