Organization
YUMA GASTROENTEROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIVESH R ANIREDDY MD (MANAGING PARTNER)
(928) 343-3084
Entity
Organization
Contact information
Practice address
1030 W 24TH ST, SUITE H, YUMA, AZ 85364-8345
(928) 344-4325
(928) 343-3084
Mailing address
PO BOX 27340, PHOENIX, PHOENIX, AZ 85061-7340
(602) 943-9200
(602) 216-3000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112955
HEALTH PARTNERS
AZ
01
—
5397003
CIGNA
AZ
01
—
5427531
AETNA
AZ
05
—
907298
—
AZ
Enumeration date
06/27/2006
Last updated
01/16/2008
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