Healthcare Provider Details

I. General information

NPI: 1477522340
Provider Name (Legal Business Name): ADRIAN ARYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N 32ND ST SUITE 220
PHOENIX AZ
85018-3953
US

IV. Provider business mailing address

1010 E MCDOWELL RD STE LL1
PHOENIX AZ
85006-2606
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-1250
  • Fax: 602-956-7466
Mailing address:
  • Phone: 602-956-1250
  • Fax: 623-321-8726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number28127
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: