Individual
PRITI SUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4540 E BASELINE RD, SUITE 115, MESA, AZ 85206-4613
(480) 306-6405
(480) 306-6409
Mailing address
4540 E BASELINE RD, SUITE 115, MESA, AZ 85206-4613
(480) 306-6405
(480) 306-6409
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
44601
AZ
207RG0100X
Gastroenterology Physician
Primary
44601
AZ
207RI0008X
Hepatology Physician
44601
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44601
MEDICAL LICENSE
AZ
Enumeration date
02/08/2007
Last updated
11/03/2011
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