M.g.t Rn Llc | |
7117 E Peralta Cir Mesa AZ 85212-9825 | |
(480) 430-0721 | |
Not Available |
Full Name | M.g.t Rn Llc |
---|---|
Speciality | Family Medicine |
Location | 7117 E Peralta Cir, Mesa, Arizona |
Authorized Official Name and Position | Jameelah Wilson (OWNER) |
Authorized Official Contact | 4804300721 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
M.g.t Rn Llc 7316 E Southern Ave Unit 6091 Mesa AZ 85216-5005 Ph: (480) 430-0721 | M.g.t Rn Llc 7117 E Peralta Cir Mesa AZ 85212-9825 Ph: (480) 430-0721 |
NPI Number | 1003448952 |
---|---|
Provider Enumeration Date | 02/09/2020 |
Last Update Date | 02/09/2020 |
Medicare PECOS PAC ID | 3173953924 |
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Medicare Enrollment ID | O20200420002059 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003448952 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Jameelah Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578939682 PECOS PAC ID: 8820305063 Enrollment ID: I20150921000509 |
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