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4902 E Shea Blvd Suite 101 Scottsdale AZ 85254-4184 | |
| (480) 214-4468 | |
| (480) 607-6883 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 4902 E Shea Blvd, Scottsdale, Arizona |
| Authorized Official Name and Position | Michael P. Dunn (PRESIDENT/CMO) |
| Authorized Official Contact | 4805452787 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
890 W Elliot Rd Suite 101 Gilbert AZ 85233-5102 Ph: (480) 545-2787 | 4902 E Shea Blvd Suite 101 Scottsdale AZ 85254-4184 Ph: (480) 214-4468 |
| NPI Number | 1770867087 |
|---|---|
| Provider Enumeration Date | 10/05/2011 |
| Last Update Date | 05/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770867087 | NPI | - | NPPES |
| 675018 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | OTC5231 (Arizona) | Secondary |
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