Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

Organization Active NPI Internal Medicine Physician · Scottsdale, AZ

NPI 1679628531 · NPPES record last updated May 26, 2021

Key facts

NPI
1679628531
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Practice address
10005 E Osborn Rd
Scottsdale, AZ 85256-4019
Phone
(602) 263-1200
Fax
(602) 263-1618
NPI assigned
Jan 23, 2007
Organization subpart
No

Authorized official

Name
Laura A Tillman, MD
Title
Cmo
Phone
(602) 263-1674

Corporate family (same tax ID) 17

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Phoenix Indian Med Cent (18 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X Yes
Endocrinology, Diabetes & Metabolism Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RE0101X
Nephrology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RN0300X
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208000000X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X
Advanced Practice Midwife
Group: 193200000X MULTI-SPECIALTY GROUP
367A00000X

Addresses

Primary practice location

10005 E Osborn Rd
Scottsdale, AZ 85256-4019

Mailing address

PO Box 95460
Cleveland, OH 44101-0033
Phone (602) 581-6088

Other identifiers

IdentifierTypeStateIssuer
P0109880OtherAZBCBSAZ
092353MedicaidAZ

Other names

  • Salt River Professional Services Doing business as

Other providers in Scottsdale, AZ

All providers in Scottsdale, AZ · Internal Medicine Physician in Arizona

Sources for this page

Verify at the official NPI Registry.