Healthcare Provider Details

I. General information

NPI: 1700957594
Provider Name (Legal Business Name): NAMITA KOTHARI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3477 S MERCY RD STE 108 (MATERNAL FETAL MEDICINE)
GILBERT AZ
85297
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 480-909-3789
  • Fax: 480-728-8891
Mailing address:
  • Phone: 602-406-4786
  • Fax: 916-636-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35551
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: