Organization
TEAM PHYSICIANS OF ARIZONA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD D CARVOLTH M.D. (PRESIDENT)
(925) 924-1600
Entity
Organization
Contact information
Practice address
6644 E BAYWOOD AVE, MESA, AZ 85206-1747
(925) 924-1600
Mailing address
PO BOX 635199, CINCINNATI, OH 45263-5199
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443747
—
AZ
01
—
AZ0855330
BS ARIZONA
AZ
01
—
CN9785
MEDICARE RR
AZ
Enumeration date
06/29/2006
Last updated
10/24/2007
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