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Organization

DISTRICT MEDICAL GROUP, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERESA CORDEIRO (CREDENTIALING MANAGER)
(602) 470-5000
Entity
Organization

Contact information

Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207V00000X
Obstetrics & Gynecology Physician
207X00000X
Orthopaedic Surgery Physician
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
208000000X
Pediatrics Physician
2084P0800X
Psychiatry Physician
2085R0202X
Diagnostic Radiology Physician
208600000X
Surgery Physician

Other

Enumeration date
08/26/2009
Last updated
09/09/2009
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