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Individual

DR. SANKALP CHOUDHRI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3155 E SOUTHERN AVE, SUITE 203, MESA, AZ 85204-5519
(480) 325-8173
(480) 325-8179
Mailing address
3155 E SOUTHERN AVE, SUITE 203, MESA, AZ 85204-5519
(480) 325-8173
(480) 325-8179

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
38218
AZ
207RP1001X
Pulmonary Disease Physician
Primary
38218
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1235274614
GROUP NPI
01
336456
GROUP MEDICAID
AZ
01
38218
AZ LICENSE
AZ
05
416390
AZ
01
Z148911
PTAN MD ANDERSON
AZ
01
Z78334
GROUP MEDICARE PTAN
AZ
Enumeration date
05/24/2007
Last updated
01/09/2012
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