SCOTTSDALE INTERNAL MEDICINE PLLC NPI 1790050409

NPI Information

NPI: 1790050409
Provider Name: SCOTTSDALE INTERNAL MEDICINE PLLC
Classification: Clinical Nurse Specialist - 364SA2200X
Entity Type: Organization

Specialization: Adult Health

Address:
4643 N 12TH ST STE 101
PHOENIX, AZ
ZIP 85014
Phone: (602) 812-3789
Get Directions

SCOTTSDALE INTERNAL MEDICINE PLLC is an adult health clinical nurse specialist in Phoenix, AZ. SCOTTSDALE INTERNAL MEDICINE PLLC NPI is 1790050409. The provider is registered as an organization entity type.

The provider's business location address is:

4643 N 12TH ST STE 101
PHOENIX, AZ
ZIP 85014-083
Phone: (602) 812-3789

The provider's authorized official is Charles Benjamin Evans .
The authorized official title is Owner and has the following contact phone number (602) 292-0552.

The enumeration date for this NPI number is 3/13/2012 and was last updated on 2/29/2024.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			No
2	364SA2200X	Clinical Nurse Specialist	Adult Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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