Provider Demographics
NPI:1972376283
Name:RISING MEDICAL GROUP PLLC
Entity type:Organization
Organization Name:RISING MEDICAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADU-AMANKWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-750-0147
Mailing Address - Street 1:14747 N NORTHSIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2631
Mailing Address - Country:US
Mailing Address - Phone:520-226-5977
Mailing Address - Fax:
Practice Address - Street 1:5325 W BUTLER DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4854
Practice Address - Country:US
Practice Address - Phone:623-931-7002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty