Healthcare Provider Details

I. General information

NPI: 1275733701
Provider Name (Legal Business Name): ANURADHA PATURI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 N 15TH ST STE. 155
PHOENIX AZ
85020-4327
US

IV. Provider business mailing address

20325 N 51ST AVE STE 130
GLENDALE AZ
85308-5677
US

V. Phone/Fax

Practice location:
  • Phone: 602-242-4928
  • Fax: 602-249-4813
Mailing address:
  • Phone: 602-459-7267
  • Fax: 602-759-6075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number44857
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: