MEDICARE: ARIZONA MOHS SURGERY, PLLC

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
1	207ND0101X	MOHS-Micrographic Surgery Physician

General Provider Information

NPI Number	:	1588297402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA MOHS SURGERY, PLLC

Provider Business Mailing Address
First Line	:	7530 N ORACLE RD STE 102
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-4451
Country	:	US
Telephone Number	:	520-612-7722
Fax Number	:	520-612-7797

Provider Business Practice Location Address
First Line	:	7530 N ORACLE RD STE 102
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-4450
Country	:	US
Telephone Number	:	520-612-7722
Fax Number	:	520-612-7797

Authorized Official
Title or Position	:	OWNER/SURGEON
Name	:	ANIR DHIR
Credential	:	MD
Telephone Number	:	520-612-7722

Provider Enumeration Date	:	02/19/2020
Last Update Date	:	09/30/2020

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