| Anasazi Medical Clinic Pc | |
|
6641 East Baywood Ave Suite #a2 Mesa AZ 85206 | |
| (480) 396-2022 | |
| (480) 396-2035 |
| Full Name | Anasazi Medical Clinic Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6641 East Baywood Ave, Mesa, Arizona |
| Authorized Official Name and Position | Tariq Khalil (OWNER) |
| Authorized Official Contact | 4803982022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anasazi Medical Clinic Pc 6641 East Baywood Ave Suite #a2 Mesa AZ 85206 Ph: (480) 396-2022 | Anasazi Medical Clinic Pc 6641 East Baywood Ave Suite #a2 Mesa AZ 85206 Ph: (480) 396-2022 |
| NPI Number | 1669428363 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 03/28/2008 |
| Medicare PECOS PAC ID | 5395733406 |
|---|---|
| Medicare Enrollment ID | O20040505001180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669428363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 22725 (Arizona) | Primary |
| Provider Name | Tariq Khalil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750337457 PECOS PAC ID: 2365430477 Enrollment ID: I20040506000165 |
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