Individual
VISHAL ATAISH GANESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10450 W MCDOWELL RD, STE 102, AVONDALE, AZ 85392-4901
(623) 846-7614
(623) 846-0993
Mailing address
P.O. BOX 29870, PHOENIX, AZ 85038
(602) 772-3805
(602) 772-3801
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
44706
AZ
207X00000X
Orthopaedic Surgery Physician
Primary
44706
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4Z0125
HEALTHNET
AZ
05
—
620765
—
AZ
Enumeration date
05/24/2007
Last updated
10/07/2011
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