| Northside Internal Medicine Associates Ps | |
|
6120 N Mayfair Spokane WA 99208 | |
| (509) 489-7483 | |
| (509) 489-4572 |
| Full Name | Northside Internal Medicine Associates Ps |
|---|---|
| Speciality | Internal Medicine |
| Location | 6120 N Mayfair, Spokane, Washington |
| Authorized Official Name and Position | Timothy J Gardner (PRESIDENT) |
| Authorized Official Contact | 5094897483 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Internal Medicine Associates Ps 6120 N Mayfair Spokane WA 99208 Ph: (509) 489-7483 | Northside Internal Medicine Associates Ps 6120 N Mayfair Spokane WA 99208 Ph: (509) 489-7483 |
| NPI Number | 1114966769 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 12/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114966769 | NPI | - | NPPES |
| 7300015 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Secondary |
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