Healthcare Provider Details

I. General information

NPI: 1033104716
Provider Name (Legal Business Name): HONORHEALTH MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 N 24TH ST SUITE B-102
PHOENIX AZ
85016-6262
US

IV. Provider business mailing address

2500 W UTOPIA RD
PHOENIX AZ
85027-4171
US

V. Phone/Fax

Practice location:
  • Phone: 602-955-6632
  • Fax: 602-381-1341
Mailing address:
  • Phone: 480-587-5314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAVAS PETRIDES
Title or Position: SVP/CEO
Credential:
Phone: 480-696-4020