MEDICARE: DR. ANDREW NAVA 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	207Q00000X	Family Medicine Physician	24355	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00230446	OTHER	AZ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	2Z0735	OTHER	AZ	HEALTHNET PIN

General Provider Information

NPI Number	:	1639285323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW NAVA M.D.

Provider Business Mailing Address
First Line	:	4530 N 32ND ST
Second Line	:	STE 104
City	:	PHOENIX
State	:	AZ
Zip	:	85018-3357
Country	:	US
Telephone Number	:	602-279-6282
Fax Number	:	602-274-2157

Provider Business Practice Location Address
First Line	:	4530 N 32ND ST
Second Line	:	STE 104
City	:	PHOENIX
State	:	AZ
Zip	:	85018-3357
Country	:	US
Telephone Number	:	602-279-6282
Fax Number	:	602-274-2157

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	08/14/2013

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