Healthcare Provider Details

I. General information

NPI: 1831524073
Provider Name (Legal Business Name): MEDICAL ONCOLOGY ASSOCIATES, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13424 E MISSION AVE
SPOKANE VALLEY WA
99216-2759
US

IV. Provider business mailing address

PO BOX 996
HAYDEN ID
83835-0996
US

V. Phone/Fax

Practice location:
  • Phone: 208-664-4026
  • Fax: 855-598-5921
Mailing address:
  • Phone: 208-664-4026
  • Fax: 855-532-5921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ARVIND CHAUDHRY
Title or Position: OWNER
Credential: MD
Phone: 208-664-4026