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General NPI Number Information
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NPI Number | 1477722700
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Entity Type | Organization
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Legal Business Name | CENTER FOR NEUROLOGY & STROKE
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 13062 WEST MCDOWELL ROAD SUITE C1
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City | AVONDALE
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State | AZ
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Zip | 85323
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Country | US
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Telephone | 602-406-3605
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Fax | 602-249-3118
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Provider Business Mailing Address
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Address Line | 6036 N 19TH AVE SUITE 506
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City | PHOENIX
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State | AZ
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Zip | 85015-2106
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Country | US
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Telephone | 602-335-0300
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Fax | 602-249-3118
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. AVINASH KHATTER
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Credential | M.D.
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Telephone | 602-335-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 38009
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License Number State | AZ
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