Individual
PETE S COURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5424 E SOUTHERN AVE, SUITE 101, MESA, AZ 85206-3621
(480) 654-6200
(480) 654-6214
Mailing address
5424 E SOUTHERN AVE, SUITE 101, MESA, AZ 85206-3621
(480) 654-6200
(480) 654-6214
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27809
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0763830
BLUE CROSS BLUE SHIELD
AZ
01
—
POO161560
RAILROAD MEDICARE
AZ
01
—
Z83970
PTAN
—
Enumeration date
09/26/2005
Last updated
12/31/2013
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