Basic Information
| Provider Information | |||||||||
| NPI: | 1437568656 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEMD, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7332 E BUTHERUS DR HNGR 1 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852608005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803395001 | ||||||||
| FaxNumber: | 4802476482 | ||||||||
| Practice Location | |||||||||
| Address1: | 7332 E BUTHERUS DR HNGR 1 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852608005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803395001 | ||||||||
| FaxNumber: | 4802476482 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2014 | ||||||||
| LastUpdateDate: | 08/13/2014 | ||||||||
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| AuthorizedOfficialLastName: | SHUFELDT | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4803395001 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD, JD, FACEP, MBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.