Individual
SHARMILA PARVATHANENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2901 N STOCKTON HILL RD STE B, KINGMAN, AZ 86401
(928) 718-0777
(928) 718-0877
Mailing address
PO BOX 3837, KINGMAN, AZ 86402-3837
(928) 718-0777
(928) 718-0877
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036126682
IL
207RN0300X
Nephrology Physician
Primary
49359
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225334840
—
AZ
Enumeration date
01/28/2011
Last updated
07/16/2018
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