Healthcare Provider Details

I. General information

NPI: 1881861953
Provider Name (Legal Business Name): SURRAJ MEDICAL ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9165 W THUNDERBIRD RD STE 101
PEORIA AZ
85381-4847
US

IV. Provider business mailing address

9165 W THUNDERBIRD RD STE 101
PEORIA AZ
85381-4847
US

V. Phone/Fax

Practice location:
  • Phone: 623-249-2100
  • Fax: 623-476-7305
Mailing address:
  • Phone: 623-249-2100
  • Fax: 623-476-7305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35075
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number35075
License Number StateAZ

VIII. Authorized Official

Name: ASHISH SACHDEVA
Title or Position: PHYSICIAN
Credential: MD
Phone: 623-249-2100