Healthcare Provider Details

I. General information

NPI: 1871568048
Provider Name (Legal Business Name): RAJEEV S KATHURIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 E SHEA BLVD SUITE 100
SCOTTSDALE AZ
85260-6635
US

IV. Provider business mailing address

8402 E SHEA BLVD SUITE 100
SCOTTSDALE AZ
85260-6635
US

V. Phone/Fax

Practice location:
  • Phone: 480-661-0700
  • Fax: 480-778-9200
Mailing address:
  • Phone: 480-661-0700
  • Fax: 480-778-9200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number21778
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: