Basic Information
| Provider Information | |||||||||
| NPI: | 1558302174 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APOGEE MEDICAL GROUP PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 708850 | ||||||||
| Address2: | |||||||||
| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840708850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013529500 | ||||||||
| FaxNumber: | 8013527976 | ||||||||
| Practice Location | |||||||||
| Address1: | 2525 E CAMELBACK RD | ||||||||
| Address2: | #1100 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6027783600 | ||||||||
| FaxNumber: | 6027783659 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 02/25/2009 | ||||||||
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| AuthorizedOfficialLastName: | HARWELL | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6027783600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 844477000 | 01 | OR | BCBS | OTHER | 858464000 | 01 | OR | BCBS | OTHER | 838334000 | 01 | OR | BCBS | OTHER | 838366000 | 01 | OR | BCBS | OTHER | DA5021 | 01 | OR | RR MEDICARE | OTHER | 858463000 | 01 | OR | BCBS | OTHER |