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NPI Code Detail

MEDICARE: DR. GREGORY L BANDY MD

MEDICARE: DR. GREGORY L BANDY MD
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
1207P00000XEmergency Medicine Physician16309AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
139-81220OTHERAZEVERCARE GROUP
2AW1936OTHERAZHEALTHNET GROUP
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4AZ0728670OTHERAZBCBS GROUP

General Provider Information

NPI Number : 1356332084
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY L BANDY MD
Provider Business Mailing Address
First Line : 2222 S DOBSON RD
Second Line : SUITE 1100
City : MESA
State : AZ
Zip : 85202-6481
Country : US
Telephone Number : 480-839-3469
Fax Number : 480-839-4182
Provider Business Practice Location Address
First Line : 5102 W CAMPBELL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85031-1703
Country : US
Telephone Number : 623-848-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 07/08/2007

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Directions to “ DR. GREGORY L BANDY MD” Practice Location

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