Provider Demographics
NPI:1922361179
Name:ARIZONA MEDICAL GROUP
Entity Type:Organization
Organization Name:ARIZONA MEDICAL GROUP
Other - Org Name:ARIZONA WOMEN'S SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HETAL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-398-1027
Mailing Address - Street 1:2352 E UNIVERSITY DR.
Mailing Address - Street 2:STE D103
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034
Mailing Address - Country:US
Mailing Address - Phone:623-398-1027
Mailing Address - Fax:623-398-1028
Practice Address - Street 1:4700 N 51ST AVE
Practice Address - Street 2:STE 5
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031
Practice Address - Country:US
Practice Address - Phone:623-398-1027
Practice Address - Fax:623-398-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty