Provider Demographics
NPI:1366854861
Name:MEDCUBED PLLC
Entity Type:Organization
Organization Name:MEDCUBED PLLC
Other - Org Name:AVEON HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:FEREIDOUNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-300-4663
Mailing Address - Street 1:7699 E PINNACLE PEAK RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6322
Mailing Address - Country:US
Mailing Address - Phone:480-300-4663
Mailing Address - Fax:480-300-4888
Practice Address - Street 1:7699 E PINNACLE PEAK RD
Practice Address - Street 2:SUITE 115
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6322
Practice Address - Country:US
Practice Address - Phone:480-300-4663
Practice Address - Fax:480-300-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty