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General NPI Number Information
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NPI Number | 1689811630
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Entity Type | Organization
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Legal Business Name | MCDOWELL WEST INTERNAL MEDICINE PC
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 13555 W MCDOWELL RD SUITE 104
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City | GOODYEAR
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State | AZ
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Zip | 85395-2624
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Country | US
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Telephone | 623-932-9636
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Fax | 623-932-9643
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Provider Business Mailing Address
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Address Line | 13555 W MCDOWELL RD SUITE 104
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City | GOODYEAR
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State | AZ
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Zip | 85395-2624
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Country | US
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Telephone | 623-932-9636
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Fax | 623-932-9643
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JOYCE ROBINSON
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Credential |
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Telephone | 623-512-4350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2166
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License Number State | AZ
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