Individual
AMIT SRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-1900
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
72527
AZ
208000000X
Pediatrics Physician
R8114
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
72527
AZ
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
R8114
TX
Other
Enumeration date
05/04/2015
Last updated
09/17/2024
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