Organization
AJITH PURUSH MD PLC
Active
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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