Provider Demographics
NPI:1083092688
Name:AMERICAN MEDICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EHREEMA
Authorized Official - Middle Name:J
Authorized Official - Last Name:NADIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-405-2423
Mailing Address - Street 1:1915 E CHANDLER BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-5117
Mailing Address - Country:US
Mailing Address - Phone:480-306-5151
Mailing Address - Fax:480-306-4648
Practice Address - Street 1:1915 E CHANDLER BLVD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-5117
Practice Address - Country:US
Practice Address - Phone:480-306-5151
Practice Address - Fax:480-306-4648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36286207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ255435Medicaid
AZ255435Medicaid