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Organization
MOHAVE NEPHROLOGY,PC
Active
Organization
MOHAVE NEPHROLOGY,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAYAVEL PALANICHAMY M.D. (PRES)
(928) 757-2050
Entity
Organization
Contact information
Practice address
3535 E ANDY DEVINE AVE, KINGMAN, AZ 86401-3412
(928) 757-2050
(928) 757-2020
Mailing address
3535 E ANDY DEVINE AVE, KINGMAN, AZ 86401-3412
(928) 757-2050
(928) 757-2020
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
27022
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
442682-02
—
AZ
Enumeration date
04/13/2010
Last updated
02/04/2014
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