Healthcare Provider Details

I. General information

NPI: 1164953147
Provider Name (Legal Business Name): GEORGINA A ADJEI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20440 N 27TH AVE
PHOENIX AZ
85027-3240
US

IV. Provider business mailing address

20440 N 27TH AVE
PHOENIX AZ
85027-3240
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-4545
  • Fax:
Mailing address:
  • Phone: 201-282-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number62876
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: