Healthcare Provider Details

I. General information

NPI: 1205709128
Provider Name (Legal Business Name): SAMEER CHOPRA MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18404 N TATUM BLVD STE 207
PHOENIX AZ
85032-1509
US

IV. Provider business mailing address

18404 N TATUM BLVD STE 207
PHOENIX AZ
85032-1509
US

V. Phone/Fax

Practice location:
  • Phone: 602-777-3113
  • Fax: 602-726-3008
Mailing address:
  • Phone: 602-777-3113
  • Fax: 602-726-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: SAMEER CHOPRA
Title or Position: PRESIDENT
Credential: MD
Phone: 602-337-8500