Organization
BANNER PHOENIX INTERNAL MEDICINE PHYSICIANS
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS E DAHLEN (SR VP FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
4400 N 32ND ST, SUITE 140, PHOENIX, AZ 85018-3953
(602) 254-4424
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
PENDING
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255741
—
AZ
Enumeration date
05/25/2007
Last updated
01/24/2008
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