Provider Demographics
NPI:1851627541
Name:MARICOPA INTEGRATED HEALTH SYSTEM
Entity Type:Organization
Organization Name:MARICOPA INTEGRATED HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/INTERNAL MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WISINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-344-5027
Mailing Address - Street 1:4244 EAST EXPEDITION WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 E ROOSEVELT ST
Practice Address - Street 2:INTERNAL MEDICINE DEPARTMENT
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4973
Practice Address - Country:US
Practice Address - Phone:602-344-1218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital