Healthcare Provider Details

I. General information

NPI: 1134609498
Provider Name (Legal Business Name): KANWAL NAVEEN SINGH BAINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 E TANGERINE RD
ORO VALLEY AZ
85755-6213
US

IV. Provider business mailing address

825 CHALKSTONE AVE
PROVIDENCE RI
02908-4728
US

V. Phone/Fax

Practice location:
  • Phone: 520-901-3500
  • Fax:
Mailing address:
  • Phone: 412-378-4053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number66071
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number66071
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLP04464
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: