Individual
DR. CHETAN S. GUJRATHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4530 E SHEA BLVD STE 180, PHOENIX, AZ 85028-6042
(602) 264-4834
(602) 254-5178
Mailing address
4530 E SHEA BLVD STE 180, PHOENIX, AZ 85028-6042
(602) 264-4834
(602) 254-5178
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
33545
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
799702
—
AZ
05
—
958978
—
AZ
01
—
AZ153810
BC/BS PROVIDER ID
AZ
Enumeration date
01/25/2006
Last updated
03/23/2023
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