Individual
NIRMALJI ODEDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3655 W. ANTHEM WY STE A-109 PMB313, ANTHEM, AZ 85086
(623) 505-4479
Mailing address
3655 W ANTHEM WAY STE A109, ANTHEM, AZ 85086-0430
(623) 505-4479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
81013
AZ
208M00000X
Hospitalist Physician
Primary
81013
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81013
TRAINING PERMIT
AZ
Enumeration date
11/30/2007
Last updated
11/10/2022
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