Organization
NOD-PRIME RHEUMATOLOGY SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI CONNER (EVP)
(602) 714-8162
Entity
Organization
Contact information
Practice address
1623 FORD AVE, WYANDOTTE, MI 48192-2303
(734) 389-7167
Mailing address
2375 E CAMELBACK RD STE 600, PHOENIX, AZ 85016-3493
(602) 714-8162
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5357970
—
MI
Enumeration date
10/20/2021
Last updated
09/11/2025
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