| Scottsdale Sports Medicine | |
|
10133 N 92nd St Suite 102 Scottsdale AZ 85258-4556 | |
| (623) 399-8606 | |
| (623) 399-9958 |
| Full Name | Scottsdale Sports Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 10133 N 92nd St, Scottsdale, Arizona |
| Authorized Official Name and Position | David Girard Carfagno (PHYSICIAN) |
| Authorized Official Contact | 6233998606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scottsdale Sports Medicine 10133 N 92nd St Suite 102 Scottsdale AZ 85258-4556 Ph: (623) 399-8606 | Scottsdale Sports Medicine 10133 N 92nd St Suite 102 Scottsdale AZ 85258-4556 Ph: (623) 399-8606 |
| NPI Number | 1962612069 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/03/2007 |
| Medicare PECOS PAC ID | 1759366560 |
|---|---|
| Medicare Enrollment ID | O20040623001561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962612069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 3227 (Arizona) | Primary |
| Provider Name | David G Carfagno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245248533 PECOS PAC ID: 3678558558 Enrollment ID: I20040623001217 |
| Provider Name | Charlann Carroll Staab |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184259962 PECOS PAC ID: 5991173551 Enrollment ID: I20221201003078 |
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