Organization
MOBILE DOC ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAI SHANNON (MANAGING MEMBER)
(480) 359-3998
Entity
Organization
Contact information
Practice address
2355 E CAMELBACK RD, STE 615, PHOENIX, AZ 85016-3458
(480) 359-3998
(480) 385-6785
Mailing address
2355 E CAMELBACK RD, STE 615, PHOENIX, AZ 85016-3458
(480) 359-3998
(480) 385-6785
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
02/15/2017
Last updated
02/15/2017
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