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BANNER -- UNIVERSITY MEDICAL GROUP

Allergy and Immunology

Phoenix, Arizona

Provider NPI: 1508809427

Organization Information:
Organization Name:  BANNER -- UNIVERSITY MEDICAL GROUP


Practice Location:
2901 N CENTRAL AVE  PHOENIX, AZ 85012 US
Tel: 602-747-4000  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207K00000XPhysicians
Allergy & Immunology
N207L00000XPhysicians
Anesthesiology
N207N00000XPhysicians
Dermatology
N207P00000XPhysicians
Emergency Medicine
N207T00000XPhysicians
Neurological Surgery
N207U00000XPhysicians
Nuclear Medicine
N207V00000XPhysicians
Obstetrics & Gynecology
N207W00000XPhysicians
Ophthalmology
N207X00000XPhysicians
Orthopaedic Surgery
N207ZP0102XPhysicians
Pathology
N208000000XPhysicians
Pediatrics
N2085R0202XPhysicians
Radiology
N207R00000XPhysicians
Internal Medicine
N261QA1903XAmbulatory Health Care Facilities
Clinic/Center
AZ
Y207Q00000XPhysicians
Family Medicine

Other Provider Identifiers:

IssuerNumberStateType
RAIL ROAD MEDICARECC6470AZ01
005638AZ05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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