Organization
AJITH PURUSH MD PLC
Active
Other names
Apurva Advanced Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AJITH PURUSH MD (MEMBER)
(928) 710-1533
Entity
Organization
Contact information
Practice address
722 N MONTEZUMA ST, PRESCOTT, AZ 86301-2002
(928) 237-9000
(928) 237-9011
Mailing address
722 N MONTEZUMA ST, PRESCOTT, AZ 86301-2002
(928) 237-9000
(928) 237-9011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33680
AZ
253Z00000X
In Home Supportive Care Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00217872
RR MEDICARE
AZ
Enumeration date
07/18/2010
Last updated
11/16/2020
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