Main Street Pediatrics

LBN: Bethesda Pediatrics Of Queen Creek
Main Street Pediatrics is an health care organization with primary practice located at 130 S 63Rd St , Mesa AZ 85206-1620. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Bethesda Pediatrics Of Queen Creek can be contacted via phone (480) 792-9200, or through Self, Stacie via phone (480) 792-9200.

Contact Information

Primary practice address
130 S 63Rd St Mesa AZ 85206-1620
Phone: (480) 792-9200
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Self, Stacie
Phone: (480) 792-9200

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1073102976
LBN Legal business name Bethesda Pediatrics Of Queen Creek
DBA Doing business as Main Street Pediatrics
Authorized official Self, Stacie
Entity Organization
Organization subpart 1 No
Enumeration date Jan 14th, 2021
Last updated Jan 20th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1073102976 NPPES
Arizona MEDICAID 538751

Popular Providers