MEDICARE: LAXMI P DHAKAL 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
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	0438053	KS
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	1196	WI
3	2084A2900X	Neurocritical Care Physician	334708	LA
4	2084N0400X	Neurology Physician	334708	LA
5	2084N0400X	Neurology Physician	1196	WI
6	2084N0400X	Neurology Physician	68162	AZ

General Provider Information

NPI Number	:	1598997348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAXMI P DHAKAL MD

Provider Business Mailing Address
First Line	:	PO BOX 20610
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85277-0610
Country	:	US
Telephone Number	:	833-723-4410
Fax Number	:	210-695-7714

Provider Business Practice Location Address
First Line	:	3719 E LOUISE DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-8314
Country	:	US
Telephone Number	:	480-985-1093
Fax Number	:	480-296-7665

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

Provider Enumeration Date	:	08/12/2009
Last Update Date	:	08/16/2024

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Directions to “ LAXMI P DHAKAL MD” Practice Location

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