MEDICARE: ADULT GASTROENTEROLOGY, P.L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	30881	AZ

General Provider Information

NPI Number	:	1104019413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADULT GASTROENTEROLOGY, P.L.L.C.

Provider Business Mailing Address
First Line	:	5815 N BLACK CANYON HWY STE 101
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2200
Country	:	US
Telephone Number	:	602-973-6666
Fax Number	:	602-812-3395

Provider Business Practice Location Address
First Line	:	5815 N BLACK CANYON HWY STE 101
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2200
Country	:	US
Telephone Number	:	602-973-6666
Fax Number	:	602-812-3395

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NADIM T. ZYADEH
Credential	:	M.D.
Telephone Number	:	602-973-6666

Provider Enumeration Date	:	08/20/2007
Last Update Date	:	01/22/2026

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