Provider Demographics
NPI:1417103599
Name:D & M MEDICAL CLINIC, PC
Entity Type:Organization
Organization Name:D & M MEDICAL CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MASHALLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHREFZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-876-0044
Mailing Address - Street 1:10503 W THUNDERBIRD BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-2746
Mailing Address - Country:US
Mailing Address - Phone:623-876-0044
Mailing Address - Fax:623-815-8141
Practice Address - Street 1:10503 W THUNDERBIRD BLVD STE 202
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2746
Practice Address - Country:US
Practice Address - Phone:623-876-0044
Practice Address - Fax:623-815-8141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty