Individual
MANOJ RAWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13460 N 94TH DRIVE, STE J-1, PEORIA, AZ 85381-4246
(623) 876-8816
(623) 298-0168
Mailing address
13460 N 94TH DR STE J1, PEORIA, AZ 85381-4246
(623) 876-8816
(623) 298-0168
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
34083
AZ
207RI0011X
Interventional Cardiology Physician
Primary
34083
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
944018
—
AZ
01
—
P00263967
MEDICARE RAIL ROAD
AZ
01
—
WCFKQ
SUN HEALTH PHYSICIANS
AZ
Enumeration date
10/12/2005
Last updated
08/18/2020
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