| Maryvale Family Practice Group Inc | |
|
4700 N 51st Ave Phoenix AZ 85031-1237 | |
| (623) 209-5555 | |
| (623) 247-1905 |
| Full Name | Maryvale Family Practice Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4700 N 51st Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Nahla Chirco (FNP) |
| Authorized Official Contact | 2482503146 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryvale Family Practice Group Inc 4700 N 51st Ave Phoenix AZ 85031-1237 Ph: (623) 209-5555 | Maryvale Family Practice Group Inc 4700 N 51st Ave Phoenix AZ 85031-1237 Ph: (623) 209-5555 |
| NPI Number | 1437661212 |
|---|---|
| Provider Enumeration Date | 11/01/2017 |
| Last Update Date | 11/01/2017 |
| Medicare PECOS PAC ID | 4082971924 |
|---|---|
| Medicare Enrollment ID | O20171130000899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437661212 | NPI | - | NPPES |
| 1750518395 | Other | MI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nahla Chirco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750518395 PECOS PAC ID: 1355497371 Enrollment ID: I20171208002029 |
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