Provider Demographics
NPI:1003040148
Name:ARIZONA RESPIRATORY MEDICINE PC
Entity Type:Organization
Organization Name:ARIZONA RESPIRATORY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KADIKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-759-1027
Mailing Address - Street 1:290 S. ALMA SCHOOL RD.
Mailing Address - Street 2:SUITE 11
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-7631
Mailing Address - Country:US
Mailing Address - Phone:480-759-1027
Mailing Address - Fax:480-759-1031
Practice Address - Street 1:290 S. ALMA SCHOOL RD.
Practice Address - Street 2:SUITE 11
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-7631
Practice Address - Country:US
Practice Address - Phone:480-759-1027
Practice Address - Fax:480-759-1031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32085207RP1001X
207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ832669Medicaid
AZZ132906Medicare PIN