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 (CREDENTIALING DIRECTOR)
(602) 470-5000
Entity
Organization
Contact information
Practice address
2601 E ROOSEVELT ST, DERMATOLOGY, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
09/09/2009
Last updated
10/01/2014
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