| Arizona Endocrinology & Diabetes Clinic Inc | |
|
18301 N 79th Ave Ste C136 Glendale AZ 85308-8471 | |
| (623) 466-3890 | |
| Not Available |
| Full Name | Arizona Endocrinology & Diabetes Clinic Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 18301 N 79th Ave Ste C136, Glendale, Arizona |
| Authorized Official Name and Position | Abdullah Hanna-moussa (OWNER) |
| Authorized Official Contact | 6234663890 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arizona Endocrinology & Diabetes Clinic Inc 18301 N 79th Ave Ste C136 Glendale AZ 85308-8471 Ph: (623) 466-3890 | Arizona Endocrinology & Diabetes Clinic Inc 18301 N 79th Ave Ste C136 Glendale AZ 85308-8471 Ph: (623) 466-3890 |
| NPI Number | 1346758653 |
|---|---|
| Provider Enumeration Date | 01/21/2018 |
| Last Update Date | 01/21/2018 |
| Medicare PECOS PAC ID | 2860755808 |
|---|---|
| Medicare Enrollment ID | O20180404002233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346758653 | NPI | - | NPPES |
| 451541 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 41644 (Arizona) | Primary |
| Provider Name | Abdullah Hanna-moussa |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1194735456 PECOS PAC ID: 9032106406 Enrollment ID: I20090911000313 |
| Provider Name | Pamela A Akers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497086474 PECOS PAC ID: 1658558184 Enrollment ID: I20110608000823 |
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