Individual
DASHANT SUBHASH KAVATHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3155 E SOUTHERN AVE, SUITE 203, MESA, AZ 85204
(480) 325-8173
(480) 325-8179
Mailing address
3155 E SOUTHERN AVE, SUITE 203, MESA, AZ 85204
(480) 325-8173
(480) 325-8179
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
44816
AZ
207RP1001X
Pulmonary Disease Physician
Primary
44816
AZ
207RP1001X
Pulmonary Disease Physician
5315021609
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
642740
—
AZ
01
—
Z78334
GROUP MEDICARE PIN
AZ
Enumeration date
05/28/2007
Last updated
12/05/2011
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