DISTRICT MEDICAL GROUP INC NPI 1124667555

NPI Information

DISTRICT MEDICAL GROUP, INC is a clinic center in Peoria, AZ. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). DISTRICT MEDICAL GROUP, INC NPI is 1124667555. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

15182 N 75TH AVE STE 180
PEORIA, AZ
ZIP 85381-722
Phone: (623) 487-3334
Fax: (623) 487-3656

The provider's authorized official is Teresa Cordeiro .
The authorized official title is Director, Credentialing and has the following contact phone number (602) 470-5519.

The CLIA number assigned to this NPI record is 03D0958431 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/2/2020 and was last updated on 2/19/2020.

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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