Provider Demographics
NPI:1093733644
Name:BHANDHUSAVEE, RUMBHA VIRASOONTARA (MD)
Entity Type:Individual
Prefix:DR
First Name:RUMBHA
Middle Name:VIRASOONTARA
Last Name:BHANDHUSAVEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RUMBHA
Other - Middle Name:
Other - Last Name:BHANDHUSAVEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:13980 N 67TH AVE
Mailing Address - Street 2:SUITE NUMBER 1
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-3715
Mailing Address - Country:US
Mailing Address - Phone:623-979-9545
Mailing Address - Fax:623-878-2126
Practice Address - Street 1:13980 N 67TH AVE
Practice Address - Street 2:SUITE NUMBER 1
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-3715
Practice Address - Country:US
Practice Address - Phone:623-979-9545
Practice Address - Fax:623-878-2126
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ66642080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine