Individual
FNU PRANAV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 N ESTRELLA PKWY # 130, GOODYEAR, AZ 85338-9271
(623) 322-2144
(623) 322-1165
Mailing address
700 N ESTRELLA PKWY # 130, GOODYEAR, AZ 85338-9271
(623) 322-2144
(623) 322-1165
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35727
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11685601
—
AZ
01
—
P00366087
RR MEDICARE
AZ
Enumeration date
07/14/2006
Last updated
06/16/2018
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