Individual
DR. ROOPASHREE PRABHUSHANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
612 W BASELINE RD, MESA, AZ 85210-6041
(480) 834-9039
(480) 964-7802
Mailing address
612 W BASELINE RD, MESA, AZ 85210-6041
(480) 834-9039
(480) 964-7802
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
49977
AZ
390200000X
Student in an Organized Health Care Education/Training Program
2013020803
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019985
—
AZ
Enumeration date
07/23/2010
Last updated
09/02/2015
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