BRIAN D DEDINSKY M.D. P.C. NPI 1114183209

NPI Information

BRIAN D DEDINSKY M.D., P.C. is a primary care clinic center in Phoenix, AZ. BRIAN D DEDINSKY M.D., P.C. NPI is 1114183209. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Dedinsky Family Medicine.

The provider's business location address is:

367 E VIRGINIA AVE
PHOENIX, AZ
ZIP 85004-202
Phone: (602) 256-6303
Fax: (602) 256-6302

The provider's authorized official is Brian David Dedinsky .
The authorized official title is Owner and has the following contact phone number (602) 256-6303.

The CLIA number assigned to this NPI record is 03D0881962 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2008 and was last updated on 6/17/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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