# REVATI MUMMANENI MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598128126
- **Authorized official:** DR. REVATI MUMMANENI MD (CEO)
- **Authorized official phone:** (248) 390-4503

## Contact information

- **Practice address:** 6895 E CAMELBACK RD, UNIT 6011, SCOTTSDALE, AZ 85251-2461
- **Practice address phone:** (248) 390-4503
- **Mailing address:** 6895 E CAMELBACK RD, UNIT 6011, SCOTTSDALE, AZ 85251-2461
- **Mailing address phone:** (248) 390-4503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 50905 | AZ | Yes |

## Other

- **Enumeration date:** 03/31/2016
- **Last updated:** 03/31/2016