Individual
SUPRIYA BHARDWAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1325 N LITCHFIELD RD STE 110, GOODYEAR, AZ 85395-1214
(623) 935-9494
(623) 935-9292
Mailing address
1325 N LITCHFIELD RD STE 110, GOODYEAR, AZ 85395-1214
(623) 935-9494
(623) 935-9292
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
62175
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62175
ARIZONA MEDICAL BOARD
AZ
Enumeration date
04/09/2018
Last updated
08/11/2021
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