Organization
ARIZONA MEDICAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANJUNATH NATHAN M.D. (PHYSICIAN)
(928) 328-8393
Entity
Organization
Contact information
Practice address
2095 W 24TH ST STE A, YUMA, AZ 85364-6243
(928) 328-8393
Mailing address
2095 W 24TH ST STE A, YUMA, AZ 85364-6243
(928) 328-8393
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36116
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153563
—
AZ
Enumeration date
10/17/2006
Last updated
12/19/2012
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