Organization
SCOTTSDALE INTERNAL MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES BENJAMIN EVANS II MD (OWNER)
(602) 292-0552
Entity
Organization
Contact information
Practice address
4643 N 12TH ST STE 101, PHOENIX, AZ 85014-4083
(602) 812-3789
Mailing address
4643 N 12TH ST STE 101, PHOENIX, AZ 85014-4083
(602) 812-3789
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
03/13/2012
Last updated
02/29/2024
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