Individual
DR. VIJAYABHANU MAHADEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12665 W SMOKEY DR # 140, #140, SURPRISE, AZ 85378-3703
(623) 219-4040
(623) 219-4050
Mailing address
12665 W SMOKEY DR # 140, #140, SURPRISE, AZ 85378-3703
(623) 219-4040
(623) 219-4050
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
0101230340
VA
207RR0500X
Rheumatology Physician
Primary
37475
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260994
—
AZ
Enumeration date
08/17/2006
Last updated
02/13/2023
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