Provider Demographics
NPI:1740485523
Name:ARCADIA PHYSICIANS TRAVEL CLINIC
Entity type:Organization
Organization Name:ARCADIA PHYSICIANS TRAVEL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-955-8700
Mailing Address - Street 1:4350 E CAMELBACK RD
Mailing Address - Street 2:F100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2701
Mailing Address - Country:US
Mailing Address - Phone:602-955-8700
Mailing Address - Fax:480-922-9860
Practice Address - Street 1:4350 E CAMELBACK RD
Practice Address - Street 2:F100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2701
Practice Address - Country:US
Practice Address - Phone:602-955-8700
Practice Address - Fax:480-922-9860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ58342083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0861590OtherBLUE CROSS BLUE SHIELD