MEDICARE: DR. MAYUR A RATHOD 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	34313	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	:	1982661799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAYUR A RATHOD M.D.

Provider Business Mailing Address
First Line	:	PO BOX 829
Second Line	:
City	:	TOLLESON
State	:	AZ
Zip	:	85353-0829
Country	:	US
Telephone Number	:	480-455-3000
Fax Number	:	866-681-9061

Provider Business Practice Location Address
First Line	:	9590 E IRONWOOD SQUARE DR STE 125
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4583
Country	:	US
Telephone Number	:	480-455-3000
Fax Number	:	866-819-6115

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	02/01/2021

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