MEDICARE: MR. DEVENDRA V GULAYA M.D.

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	207R00000X	Internal Medicine Physician	27571	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336132596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DEVENDRA V GULAYA M.D.

Provider Business Mailing Address
First Line	:	10320 W MCDOWELL RD
Second Line	:	BLDG N1445
City	:	AVONDALE
State	:	AZ
Zip	:	85392-4863
Country	:	US
Telephone Number	:	623-547-2100
Fax Number	:	623-547-3005

Provider Business Practice Location Address
First Line	:	10320 W MCDOWELL RD
Second Line	:	BLDG N1445
City	:	AVONDALE
State	:	AZ
Zip	:	85392-4863
Country	:	US
Telephone Number	:	623-547-2100
Fax Number	:	623-547-3005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	02/15/2011

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Directions to “ MR. DEVENDRA V GULAYA M.D.” Practice Location

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