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NPI Code Detail

MEDICARE: GOODYEAR FAMILY MEDICINE PC

MEDICARE: GOODYEAR FAMILY MEDICINE PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center28344AZ

General Provider Information

NPI Number : 1104015015
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOODYEAR FAMILY MEDICINE PC
Provider Business Mailing Address
First Line : 10320 W MCDOWELL RD
Second Line : BLDG. I, STE#9029
City : AVONDALE
State : AZ
Zip : 85392-4863
Country : US
Telephone Number : 623-925-5660
Fax Number : 623-932-3898
Provider Business Practice Location Address
First Line : 10320 W MCDOWELL RD
Second Line : BLDG. I, STE.9029
City : AVONDALE
State : AZ
Zip : 85392-4863
Country : US
Telephone Number : 623-925-5660
Fax Number : 623-932-3898
Authorized Official
Title or Position : OWNER
Name : DR. KAMEL SADEK
Credential : M.D.
Telephone Number : 623-925-5660
Provider Enumeration Date : 10/16/2007
Last Update Date : 02/11/2011

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Directions to “GOODYEAR FAMILY MEDICINE PC ” Practice Location

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