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NPI Code Detail

MEDICARE: DR. PRAVEENA USHA JAIDEV MD

MEDICARE: DR. PRAVEENA USHA JAIDEV MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician78386AZ

General Provider Information

NPI Number : 1154707024
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRAVEENA USHA JAIDEV MD
Provider Business Mailing Address
First Line : 9201 W THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-3332
Country : US
Telephone Number : 623-327-4000
Fax Number :
Provider Business Practice Location Address
First Line : 9201 W THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-3332
Country : US
Telephone Number : 623-327-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2015
Last Update Date : 05/06/2026

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Directions to “ DR. PRAVEENA USHA JAIDEV MD” Practice Location

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