| Arizona Valley Medicine Pllc | |
|
7550 N 19th Ave Suite 103 Phoenix AZ 85021-7980 | |
| (602) 995-5909 | |
| (602) 864-9233 |
| Full Name | Arizona Valley Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 7550 N 19th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Daniel T Zoeteman (PRESIDENTT/PROVIDER) |
| Authorized Official Contact | 6029955909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arizona Valley Medicine Pllc 7550 N 19th Ave Suite 103 Phoenix AZ 85021-7980 Ph: (602) 995-5909 | Arizona Valley Medicine Pllc 7550 N 19th Ave Suite 103 Phoenix AZ 85021-7980 Ph: (602) 995-5909 |
| NPI Number | 1538694252 |
|---|---|
| Provider Enumeration Date | 05/01/2017 |
| Last Update Date | 05/01/2017 |
| Medicare PECOS PAC ID | 4587931068 |
|---|---|
| Medicare Enrollment ID | O20170605002050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538694252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel T Zoeteman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104969310 PECOS PAC ID: 8022101724 Enrollment ID: I20070912000046 |
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