Provider Demographics
NPI:1508867839
Name:GAIDICI, ADRIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:
Last Name:GAIDICI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 E VIRGINIA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1214
Mailing Address - Country:US
Mailing Address - Phone:602-200-8988
Mailing Address - Fax:602-200-8878
Practice Address - Street 1:370 E VIRGINIA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1214
Practice Address - Country:US
Practice Address - Phone:602-200-8988
Practice Address - Fax:602-200-8878
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31367207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0737400OtherBLUE CROSS BLUE SHIELD
AZA7488429OtherAETNA
AZ804923Medicaid
AZ804923Medicaid
AZH74427Medicare UPIN