Mahadevan, Vijayabhanu
Mahadevan, Vijayabhanu is an individual health care provider with primary practice located at 12665 W Smokey Dr # 140 #140, Surprise AZ 85378-3703. She recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as her primary health care specialty. Mahadevan, Vijayabhanu can be contacted via phone (623) 219-4040.Contact Information
Primary practice address
12665 W Smokey Dr # 140 #140
Surprise AZ 85378-3703
Phone: (623) 219-4040
Fax: (623) 219-4050
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 0101230340 | Virginia |
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 37475 | Arizona |
Profile Details
| NPI number | 1083727333 |
|---|---|
| LBN Legal business name | Mahadevan, Vijayabhanu |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2006 |
| Last updated | Feb 13th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083727333 | NPPES |
| Arizona | MEDICAID | 260994 |
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