Provider Demographics
NPI:1851379879
Name:PARIDES, GEORGE C (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:C
Last Name:PARIDES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3638 E SOUTHERN AVE
Mailing Address - Street 2:STE C 108
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-2563
Mailing Address - Country:US
Mailing Address - Phone:480-834-0771
Mailing Address - Fax:480-834-1136
Practice Address - Street 1:3638 E SOUTHERN AVE
Practice Address - Street 2:STE C 108
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2563
Practice Address - Country:US
Practice Address - Phone:480-834-0771
Practice Address - Fax:480-834-1136
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ1938207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ270645Medicaid
AZ270645Medicaid