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General NPI Number Information
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NPI Number | 1467567883
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Entity Type | Individual
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Provider Name | RAJESH PRAFUL DAULAT DPM
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 6677 W THUNDERBIRD RD STE J171-172
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City | GLENDALE
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State | AZ
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Zip | 85306-3732
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Country | US
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Telephone | 623-977-6245
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Fax | 623-977-6280
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Provider Business Mailing Address
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Address Line | 6677 W THUNDERBIRD RD J171/ J172
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City | GLENDALE
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State | AZ
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Zip | 85306-3709
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Country | US
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Telephone | 623-977-6245
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Fax | 623-977-6280
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0547
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License Number State | AZ
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