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Individual

DR. GREGORY L BANDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5102 W CAMPBELL AVE, PHOENIX, AZ 85031-1703
(623) 848-5000
Mailing address
2222 S DOBSON RD, SUITE 1100, MESA, AZ 85202-6481
(480) 839-3469
(480) 839-4182

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16309
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
294819
AZ
01
39-81220
EVERCARE GROUP
AZ
01
AW1936
HEALTHNET GROUP
AZ
01
AZ0728670
BCBS GROUP
AZ
Enumeration date
11/02/2005
Last updated
07/08/2007
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