Provider Demographics
NPI:1437568656
Name:MEMD, INC
Entity Type:Organization
Organization Name:MEMD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHUFELDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, JD, FACEP, MBA
Authorized Official - Phone:480-339-5001
Mailing Address - Street 1:7332 E BUTHERUS DR HNGR 1
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-8005
Mailing Address - Country:US
Mailing Address - Phone:480-339-5001
Mailing Address - Fax:480-247-6482
Practice Address - Street 1:7332 E BUTHERUS DR HNGR 1
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-8005
Practice Address - Country:US
Practice Address - Phone:480-339-5001
Practice Address - Fax:480-247-6482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care