Organization
ASSOCIATED DESERT GASTROENTEROLOGISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PREM C KUMAR MD (OWNER)
(480) 985-9005
Entity
Organization
Contact information
Practice address
215 S POWER RD, # 102, MESA, AZ 85206-5235
(480) 985-9005
(480) 396-9974
Mailing address
215 S POWER RD, SUITE 102, MESA, AZ 85206-5235
(480) 985-9005
(480) 396-9974
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
12854
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002430
BC/BS
AZ
Enumeration date
11/15/2007
Last updated
11/04/2014
Update your record
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