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 (CREDENTIALING DIRECTOR)
(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
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
207VC0200X
Critical Care Medicine (Obstetrics & Gynecology) Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
2086S0102X
Surgical Critical Care Physician
—
—
Other
Enumeration date
11/19/2009
Last updated
10/01/2014
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