Individual
VAMSI ROKKAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6622 N 91ST AVE STE 200, GLENDALE, AZ 85305-2569
(623) 547-4668
(623) 535-7869
Mailing address
6622 N 91ST AVE STE 220, GLENDALE, AZ 85305-2569
(602) 759-6883
(602) 224-3358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
40917
KY
207RN0300X
Nephrology Physician
Primary
49713
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000528055
ANTHEM - CMA
KY
01
—
000023028O
HUMANA - CMA
KY
01
—
089054
SIHO
KY
01
—
0998869
MEDICARE - KY
KY
01
—
200877630
MEDICAID - IN
IN
01
—
2391971
CIGNA - CMA
KY
01
—
2858299000
PASSPORT ADVTG - CMA
KY
01
—
50015843
PASSPORT - CMA
KY
05
—
7100006180
—
IN
05
—
958702
—
AZ
01
—
P00439730
RAILROAD MEDICARE - KY
KY
01
—
TP218
MEDICAL LICENSE
KY
01
—
Z171026
MEDICARE PTAN - AZ
AZ
Enumeration date
05/11/2007
Last updated
12/04/2019
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