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Organization

DISTRICT MEDICAL GROUP, INC

Active
Parent organization
DISTRICT MEDICAL GROUP, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
DISTRICT MEDICAL GROUP, INC
Authorized official
TERESA CORDEIRO (CREDENTIAING DIRECTOR)
(602) 470-5000
Entity
Organization

Contact information

Practice address
1800 E FLORENCE BLVD, PATHOLOGY, CASA GRANDE, AZ 85222-5303
(520) 426-6320
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
207ZD0900X
Dermatopathology (Pathology) Physician
207ZP0101X
Anatomic Pathology Physician
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
207ZP0104X
Chemical Pathology Physician
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician

Other

Enumeration date
08/26/2009
Last updated
10/01/2014
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