Healthcare Provider Details

I. General information

NPI: 1447530027
Provider Name (Legal Business Name): ARIZONA INJURY MEDICAL ASSOCIATES, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4840 E INDIAN SCHOOL RD SUITE 104
PHOENIX AZ
85018-5500
US

IV. Provider business mailing address

PO BOX 5277
LACEY WA
98509-5277
US

V. Phone/Fax

Practice location:
  • Phone: 480-347-0941
  • Fax: 480-222-7074
Mailing address:
  • Phone: 480-347-0941
  • Fax: 480-222-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number44737
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number45185
License Number StateAZ

VIII. Authorized Official

Name: DEMITRI A. ADARMES
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 480-347-0941