Provider Demographics
NPI:1144906330
Name:GROBECK, DORY ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:DORY
Middle Name:ELIZABETH
Last Name:GROBECK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 E CAMELBACK RD STE 155
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2843
Mailing Address - Country:US
Mailing Address - Phone:480-626-2444
Mailing Address - Fax:
Practice Address - Street 1:4455 E CAMELBACK RD STE 155
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2843
Practice Address - Country:US
Practice Address - Phone:480-626-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ363AM0700X
AZ9783363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical