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General NPI Number Information
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NPI Number | 1679071534
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Entity Type | Organization
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Legal Business Name | SOVANI PLLC
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 2270 S RIDGEVIEW DR STE 207
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City | YUMA
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State | AZ
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Zip | 85364-8880
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Country | US
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Telephone | 928-783-4640
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Fax | 928-276-4730
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Provider Business Mailing Address
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Address Line | 3685 S 18TH AVE
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City | YUMA
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State | AZ
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Zip | 85365-3943
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Country | US
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Telephone | 304-771-0217
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANTWANA VINAYAK SOVANI
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Credential | MD
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Telephone | 304-771-0217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 37029
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License Number State | AZ
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