Provider Demographics
NPI:1962668434
Name:SCOTTSDALE INFECTIOUS DISEASES PC
Entity Type:Organization
Organization Name:SCOTTSDALE INFECTIOUS DISEASES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-250-5623
Mailing Address - Street 1:P.O. BOX 6043
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85261-6043
Mailing Address - Country:US
Mailing Address - Phone:480-250-5623
Mailing Address - Fax:480-949-2091
Practice Address - Street 1:9003 E. SHEA BLVD
Practice Address - Street 2:SCOTTSDALE
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-250-5623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28572174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty