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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 (CREDENTIALING DIRECTOR)
(602) 470-5000
Entity
Organization

Contact information

Practice address
2601 E ROOSEVELT ST, RADIOLOGY, PHOENIX, AZ 85008-4973
(602) 344-5000
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
2085N0700X
Neuroradiology Physician
2085N0904X
Nuclear Radiology Physician
2085P0229X
Pediatric Radiology Physician
2085R0202X
Diagnostic Radiology Physician
Primary
2085R0203X
Therapeutic Radiology Physician
2085R0204X
Vascular & Interventional Radiology Physician
2085U0001X
Diagnostic Ultrasound Physician

Other

Enumeration date
09/09/2009
Last updated
10/01/2014
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