MEDICARE: ADVANCED MINIMALLY INVASIVE SURGICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician

General Provider Information

NPI Number	:	1003664152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MINIMALLY INVASIVE SURGICAL

Provider Business Mailing Address
First Line	:	202 E EARLL DR STE 360
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2677
Country	:	US
Telephone Number	:	480-788-5621
Fax Number	:	480-779-1277

Provider Business Practice Location Address
First Line	:	1134 E UNIVERSITY DR STE 111
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-8048
Country	:	US
Telephone Number	:	480-788-5621
Fax Number	:	480-779-1277

Authorized Official
Title or Position	:	OWNER
Name	:	KIUP ALEXANDER KIM
Credential	:
Telephone Number	:	480-323-6072

Provider Enumeration Date	:	05/13/2024
Last Update Date	:	05/13/2024

Similar Medicare Providers

1598753659 — JAMES P. SCHLICHTING, D.O., PLLC
Practice Location Address:

1134 E UNIVERSITY DR , STE 114
MESA, AZ
85203-8048

Practice Phone: 480-834-9575
Practice Fax: 480-834-4497

1700059227 — SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC
Practice Location Address:

1134 E UNIVERSITY DR , STE 101
MESA, AZ
85203-8048

Practice Phone: 480-464-3851
Practice Fax: 480-668-1460

1588824098 — DR. USMA SHAHEEN AHMAD MD MBBS
Practice Location Address:

1134 E UNIVERSITY DR STE 111
MESA, AZ
85203-8048

Practice Phone: 480-398-1220
Practice Fax: 480-398-1230

1003399650 — TRUE PATRIOT CONSULTING, INC.
Practice Location Address:

1134 E UNIVERSITY DR STE 111
MESA, AZ
85203-8048

Practice Phone: 480-398-1220
Practice Fax: 480-398-1238

1811673411 — STEADFAST HEALTH LLC
Practice Location Address:

1134 E UNIVERSITY DR STE 110
MESA, AZ
85203-8048

Practice Phone: 480-869-7180
Practice Fax:

1225913577 — HERITAGE ACADEMY GATEWAY, INC.
Practice Location Address:

8048 E GERMANN RD BLDG 4
MESA, AZ
85212-5302

Practice Phone: 480-461-4400
Practice Fax: 480-498-5073

Directions to “ADVANCED MINIMALLY INVASIVE SURGICAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.