MEDICARE: APOGEE MEDICAL GROUP ALASKA

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1356398879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APOGEE MEDICAL GROUP ALASKA

Provider Business Mailing Address
First Line	:	PO BOX 708818
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84070-8818
Country	:	US
Telephone Number	:	801-352-9500
Fax Number	:	801-352-7976

Provider Business Practice Location Address
First Line	:	2525 E CAMELBACK RD
Second Line	:	#1100
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4219
Country	:	US
Telephone Number	:	602-778-3600
Fax Number	:	602-778-3659

Authorized Official
Title or Position	:	CFO
Name	:	KAREN HARWELL
Credential	:
Telephone Number	:	602-778-3600

Provider Enumeration Date	:	05/29/2006
Last Update Date	:	08/22/2020

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