1528074010 NPI number — DESERT NEPHROLOGY & HYPERTENSION, INC.

Table of content: DR. MELVIN BRUCE CARTER M.D. (NPI 1134125636)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528074010 NPI number — DESERT NEPHROLOGY & HYPERTENSION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DESERT NEPHROLOGY & HYPERTENSION, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528074010
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10503 W THUNDERBIRD BLVD STE 113
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUN CITY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85351-3047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-583-6420
Provider Business Mailing Address Fax Number:
623-583-6421

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10503 W THUNDERBIRD BLVD STE 113
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUN CITY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85351-3047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-583-6420
Provider Business Practice Location Address Fax Number:
623-583-6421
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARISE
Authorized Official First Name:
MARIO
Authorized Official Middle Name:
THOMAS
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
623-583-6420

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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