Provider Demographics
NPI:1194993600
Name:ACCREDITED INTERNAL MEDICINE P.C.
Entity type:Organization
Organization Name:ACCREDITED INTERNAL MEDICINE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:CARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-961-0014
Mailing Address - Street 1:2875 W. RAY RD
Mailing Address - Street 2:SUITE 6-317
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224
Mailing Address - Country:US
Mailing Address - Phone:480-961-0014
Mailing Address - Fax:
Practice Address - Street 1:921 W CAMELBACK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013
Practice Address - Country:US
Practice Address - Phone:480-961-0014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ169187Medicaid
AZZ74048Medicare PIN
AZ169187Medicaid
AZF60966Medicare UPIN