Healthcare Provider Details

I. General information

NPI: 1598775611
Provider Name (Legal Business Name): HARSH VARDHAN DUPHARE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/11/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 W 16TH ST
YUMA AZ
85364-4430
US

IV. Provider business mailing address

2400 S AVENUE A
YUMA AZ
85364-7127
US

V. Phone/Fax

Practice location:
  • Phone: 928-344-4325
  • Fax: 928-344-3084
Mailing address:
  • Phone: 928-344-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2023040231
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: