Healthcare Provider Details

I. General information

NPI: 1467849422
Provider Name (Legal Business Name): RAJIV SIDDARAMU MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 N 91ST ST STE A115
SCOTTSDALE AZ
85258-5036
US

IV. Provider business mailing address

3219 E CAMELBACK RD # 224
PHOENIX AZ
85018-2307
US

V. Phone/Fax

Practice location:
  • Phone: 602-753-8120
  • Fax: 602-801-3865
Mailing address:
  • Phone: 602-753-8120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAJIV SIDDARAMU
Title or Position: OWNER
Credential: MD
Phone: 602-753-8120