Healthcare Provider Details

I. General information

NPI: 1780047985
Provider Name (Legal Business Name): ARTHRITIS CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12665 W SMOKEY DR SUITE 140
SURPRISE AZ
85378-3703
US

IV. Provider business mailing address

12665 W SMOKEY DR STE 140
SURPRISE AZ
85378-3732
US

V. Phone/Fax

Practice location:
  • Phone: 623-219-4040
  • Fax: 623-219-4050
Mailing address:
  • Phone: 623-219-4040
  • Fax: 623-219-4050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number37475
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DR. VIJAYABHANU MAHADEVAN
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 623-219-4040