| Maricopa Physicians Pllc | |
|
6250 N 19th Ave Phoenix AZ 85015-1565 | |
| (480) 729-4870 | |
| Not Available |
| Full Name | Maricopa Physicians Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6250 N 19th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Fadi Alrabadi (MEMBER) |
| Authorized Official Contact | 4807294870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maricopa Physicians Pllc Po Box 39292 Phoenix AZ 85069-9292 Ph: (480) 729-4870 | Maricopa Physicians Pllc 6250 N 19th Ave Phoenix AZ 85015-1565 Ph: (480) 729-4870 |
| NPI Number | 1124599816 |
|---|---|
| Provider Enumeration Date | 12/06/2018 |
| Last Update Date | 12/06/2018 |
| Medicare PECOS PAC ID | 7315271079 |
|---|---|
| Medicare Enrollment ID | O20190628002611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124599816 | NPI | - | NPPES |
| 49923 | Other | AZ | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Manju Krishnamenon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366733560 PECOS PAC ID: 2769650662 Enrollment ID: I20110720000378 |
| Provider Name | Fadi K Alrabadi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609131499 PECOS PAC ID: 6507171105 Enrollment ID: I20150811005276 |
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