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 (DIRECTOR, CREDENTIALING)
(602) 470-5519
Entity
Organization
Contact information
Practice address
14155 N 83RD AVE STE A105, PEORIA, AZ 85381-5640
(623) 486-7700
(623) 486-7703
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
(602) 470-5064
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
475747
—
AZ
Enumeration date
02/19/2020
Last updated
02/19/2020
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