| Quickmd Medical Group Pa | |
|
4600 E Washington St Ste 300 Phoenix AZ 85034-1908 | |
| (888) 878-4256 | |
| Not Available |
| Full Name | Quickmd Medical Group Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 4600 E Washington St Ste 300, Phoenix, Arizona |
| Authorized Official Name and Position | Katrina Merritt (SENIOR MANAGER, CREDENTIALING) |
| Authorized Official Contact | 8135965726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quickmd Medical Group Pa 3865 Holcomb Bridge Rd Peachtree Corners GA 30092-2205 Ph: () - | Quickmd Medical Group Pa 4600 E Washington St Ste 300 Phoenix AZ 85034-1908 Ph: (888) 878-4256 |
| NPI Number | 1174243695 |
|---|---|
| Provider Enumeration Date | 09/02/2022 |
| Last Update Date | 01/15/2024 |
| Certification Date | 01/15/2024 |
| Medicare PECOS PAC ID | 2961898648 |
|---|---|
| Medicare Enrollment ID | O20220927001283 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174243695 | NPI | - | NPPES |
| Provider Name | Daniel J Clark |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003017229 PECOS PAC ID: 9931258159 Enrollment ID: I20130219000165 |
| Provider Name | Ellena Lois Boddie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689673790 PECOS PAC ID: 0840399515 Enrollment ID: I20210412000518 |
| Provider Name | Anthony T Mistretta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720577877 PECOS PAC ID: 3476952342 Enrollment ID: I20210526000096 |
| Provider Name | Talib N Omer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396039822 PECOS PAC ID: 2668777152 Enrollment ID: I20220927001375 |
| Provider Name | Alexander Q Lam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487281689 PECOS PAC ID: 5799100236 Enrollment ID: I20230404000834 |
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