| Mesa Physician Group | |
|
5151 E Broadway Rd Ste 105 Mesa AZ 85206-1346 | |
| (480) 809-6587 | |
| Not Available |
| Full Name | Mesa Physician Group |
|---|---|
| Speciality | General Practice |
| Location | 5151 E Broadway Rd Ste 105, Mesa, Arizona |
| Authorized Official Name and Position | Jeremiah Faber (CEO) |
| Authorized Official Contact | 4802583635 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mesa Physician Group Po Box 964 Gilbert AZ 85299-0964 Ph: (480) 366-4489 | Mesa Physician Group 5151 E Broadway Rd Ste 105 Mesa AZ 85206-1346 Ph: (480) 809-6587 |
| NPI Number | 1104447788 |
|---|---|
| Provider Enumeration Date | 05/05/2020 |
| Last Update Date | 05/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104447788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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