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General NPI Number Information
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NPI Number | 1184426116
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Entity Type | Organization
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Legal Business Name | EVEXIA MEDICAL GROUP INC
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 6350 S MAPLE AVE
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City | TEMPE
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State | AZ
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Zip | 85283-2857
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Country | US
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Telephone | 602-753-5155
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6227
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City | SCOTTSDALE
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State | AZ
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Zip | 85261-6227
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Country | US
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Telephone | 602-753-5155
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Fax |
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Authorized Official
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Title or Position | OWNDER/PHYSICIAN
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Name | DR. AMRITA DHANJAL-REDDY
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Credential | MD
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Telephone | 602-750-1479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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