Organization
DISTRICT MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA CORDIERO (CREDENTIALING MANAGER)
(602) 470-5000
Entity
Organization
Contact information
Practice address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA 0800
AZ
Other
Enumeration date
10/25/2011
Last updated
10/26/2011
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