| Memd Provider Network Llc | |
|
6910 E Chauncey Ln Ste 220 Phoenix AZ 85054-5162 | |
| (480) 339-4573 | |
| Not Available |
| Full Name | Memd Provider Network Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6910 E Chauncey Ln Ste 220, Phoenix, Arizona |
| Authorized Official Name and Position | Glenn Dean (CFO) |
| Authorized Official Contact | 4803394573 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Memd Provider Network Llc 6910 E Chauncey Ln Ste 220 Phoenix AZ 85054-5162 Ph: (480) 339-4573 | Memd Provider Network Llc 6910 E Chauncey Ln Ste 220 Phoenix AZ 85054-5162 Ph: (480) 339-4573 |
| NPI Number | 1376154625 |
|---|---|
| Provider Enumeration Date | 08/11/2020 |
| Last Update Date | 09/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376154625 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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