Healthcare Provider Details

I. General information

NPI: 1508817842
Provider Name (Legal Business Name): RAJEEV ACHARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 W THOMAS RD
PHOENIX AZ
85037-3332
US

IV. Provider business mailing address

9201 W THOMAS RD
PHOENIX AZ
85037-3332
US

V. Phone/Fax

Practice location:
  • Phone: 623-327-7313
  • Fax:
Mailing address:
  • Phone: 623-327-7313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number40981
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number40981
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: