Healthcare Provider Details

I. General information

NPI: 1184535346
Provider Name (Legal Business Name): DUO MEDICAL GROUP OF ARIZONA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 W BASELINE RD # 182-5671
PHOENIX AZ
85041-6574
US

IV. Provider business mailing address

980 N MICHIGAN AVE STE 1998
CHICAGO IL
60611-7504
US

V. Phone/Fax

Practice location:
  • Phone: 855-386-2799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRANDALYNNE FLEMMING
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 814-470-3634