Basic Information
| Provider Information | |||||||||
| NPI: | 1104039114 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTERNAL MEDICINE OF ARIZONA PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 E CAMELBACK RD | ||||||||
| Address2: | SUITE 122 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850182322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025221900 | ||||||||
| FaxNumber: | 6023813821 | ||||||||
| Practice Location | |||||||||
| Address1: | 3333 E CAMELBACK RD | ||||||||
| Address2: | SUITE 122 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850182322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025221900 | ||||||||
| FaxNumber: | 6023813281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2007 | ||||||||
| LastUpdateDate: | 07/27/2021 | ||||||||
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| AuthorizedOfficialLastName: | KUHL | ||||||||
| AuthorizedOfficialFirstName: | WAYNE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 6025221900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 07/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 7625 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.