Individual
DR. SHIVAKUMAR VIGNESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2946 E BANNER GATEWAY DR., SUITE 400, GILBERT, AZ 85234
(480) 256-3332
(813) 449-8028
Mailing address
2946 E BANNER GATEWAY DR., SUITE 400, GILBERT, AZ 85234
(480) 256-3332
(813) 449-8028
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
040551
CT
207RG0100X
Gastroenterology Physician
Primary
64480
AZ
207RG0100X
Gastroenterology Physician
ME102765
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001405514
—
CT
Enumeration date
12/05/2005
Last updated
12/28/2021
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