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General NPI Number Information
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NPI Number | 1831407253
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Entity Type | Organization
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Legal Business Name | PREMIERE MEDICAL CONSULTANTS
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 09/20/2010
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Provider Practice Location Address
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Address Line | 8433 N BLACK CANYON HWY STE 136
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City | PHOENIX
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State | AZ
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Zip | 85021
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Country | US
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Telephone | 602-326-7961
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Fax |
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Provider Business Mailing Address
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Address Line | P O BOX 38039
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City | PHOENIX
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State | AZ
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Zip | 85069
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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 | PRESIDENT
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Name | DR. CHRISTOPHER SHAWN RAY
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Credential |
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Telephone | 602-326-7961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | AZ
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