Provider Demographics
NPI:1164124632
Name:INFECTIOUS DISEASE PARTNERS LLC
Entity type:Organization
Organization Name:INFECTIOUS DISEASE PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NEEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-646-8139
Mailing Address - Street 1:PO BOX 2510
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85214-2510
Mailing Address - Country:US
Mailing Address - Phone:602-432-0146
Mailing Address - Fax:
Practice Address - Street 1:19841 N 27TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4003
Practice Address - Country:US
Practice Address - Phone:312-646-8139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty