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General NPI Number Information
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NPI Number | 1003302480
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Entity Type | Organization
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Legal Business Name | MD CENTERS LLC
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 7814 N VIA DE LA MONTANA
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3303
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Country | US
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Telephone | 480-848-1428
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Fax |
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Provider Business Mailing Address
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Address Line | 7814 N VIA DE LA MONTANA
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3303
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER/PRINCIPAL
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Name | DR. IGOR MITRESKI
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Credential | MD
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Telephone | 201-893-5232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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