Provider Demographics
NPI:1982725982
Name:DEMETRI N. PANAYI, M.D., P.C.
Entity type:Organization
Organization Name:DEMETRI N. PANAYI, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRI
Authorized Official - Middle Name:N
Authorized Official - Last Name:PANAYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-844-7100
Mailing Address - Street 1:1500 S DOBSON RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4713
Mailing Address - Country:US
Mailing Address - Phone:480-844-7100
Mailing Address - Fax:480-512-5486
Practice Address - Street 1:1500 S DOBSON RD
Practice Address - Street 2:SUITE 203
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4713
Practice Address - Country:US
Practice Address - Phone:480-844-7100
Practice Address - Fax:480-512-5486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28428174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty