| Wilmot Primary Care Group, Pllc | |
|
603 N Wilmot Rd Ste 201 Tucson AZ 85711-2701 | |
| (520) 790-1556 | |
| (520) 620-9719 |
| Full Name | Wilmot Primary Care Group, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 603 N Wilmot Rd Ste 201, Tucson, Arizona |
| Authorized Official Name and Position | Talal Alsbiei (OWNER/PROVIDER) |
| Authorized Official Contact | 5207901556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilmot Primary Care Group, Pllc 603 N Wilmot Rd Ste 201 Tucson AZ 85711-2701 Ph: (520) 790-1556 | Wilmot Primary Care Group, Pllc 603 N Wilmot Rd Ste 201 Tucson AZ 85711-2701 Ph: (520) 790-1556 |
| NPI Number | 1568870426 |
|---|---|
| Provider Enumeration Date | 07/23/2014 |
| Last Update Date | 12/15/2014 |
| Medicare PECOS PAC ID | 5395967301 |
|---|---|
| Medicare Enrollment ID | O20141106001311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568870426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Bijay Sanjeev |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811983216 PECOS PAC ID: 9739176538 Enrollment ID: I20040427000271 |
| Provider Name | Nicholas R Bastiampillai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093750242 PECOS PAC ID: 4082672217 Enrollment ID: I20041222000260 |
| Provider Name | Talal Alsbiei |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740367549 PECOS PAC ID: 4082669023 Enrollment ID: I20050314000209 |
| Provider Name | Maria E Pina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518934074 PECOS PAC ID: 7618992298 Enrollment ID: I20051012000975 |
| Provider Name | Laura Christine Moncada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609254317 PECOS PAC ID: 3779894357 Enrollment ID: I20150623002777 |
| Provider Name | Mosab A Frefer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659800977 PECOS PAC ID: 0244659696 Enrollment ID: I20201004000003 |
| Provider Name | Noelle Guiriba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972108082 PECOS PAC ID: 7618381161 Enrollment ID: I20210125003206 |
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