Provider Demographics
NPI:1801008834
Name:NORGAARD, CORI (DO)
Entity Type:Individual
Prefix:DR
First Name:CORI
Middle Name:
Last Name:NORGAARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2145 W SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4715
Mailing Address - Country:US
Mailing Address - Phone:480-412-3767
Mailing Address - Fax:480-412-3900
Practice Address - Street 1:20325 N 51ST AVE BLDG 9
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5674
Practice Address - Country:US
Practice Address - Phone:623-249-4928
Practice Address - Fax:623-249-4971
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR943207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ131286Medicare UPIN