Healthcare Provider Details

I. General information

NPI: 1457515579
Provider Name (Legal Business Name): MADHURI DHUPATI & ASSOCIATES MD PC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12647 W SMOKEY DR STE 119
SURPRISE AZ
85378
US

IV. Provider business mailing address

12647 W SMOKEY DR STE 119
SURPRISE AZ
85378-3799
US

V. Phone/Fax

Practice location:
  • Phone: 623-544-1700
  • Fax: 623-544-7544
Mailing address:
  • Phone: 623-544-1700
  • Fax: 623-544-7544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25819
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number25819
License Number StateAZ

VIII. Authorized Official

Name: MADHURI DHUPATI
Title or Position: MD
Credential: MD
Phone: 623-544-1700