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NPI Code Detail

MEDICARE: DR. ALLEN STUART MANDIR MD

MEDICARE:  DR. ALLEN STUART MANDIR  MD
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
12084N0600XClinical Neurophysiology Physician89391SC
22084N0600XClinical Neurophysiology PhysicianU0717TX
32084N0400XNeurology Physician68400AZ
42084N0600XClinical Neurophysiology PhysicianMD034282DC
52084N0600XClinical Neurophysiology PhysicianD0054114MD
62084N0600XClinical Neurophysiology PhysicianEMC0002637MI
72084N0600XClinical Neurophysiology Physician01059595AIN

General Provider Information

NPI Number : 1396744934
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLEN STUART MANDIR MD
Provider Business Mailing Address
First Line : 336 22ND AVE N
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1844
Country : US
Telephone Number : 615-346-8182
Fax Number : 877-870-7862
Provider Business Practice Location Address
First Line : 13400 E SHEA BLVD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85259-5499
Country : US
Telephone Number : 480-301-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 04/29/2026

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Directions to “ DR. ALLEN STUART MANDIR MD” Practice Location

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