Provider Demographics
NPI:1124408232
Name:ALLIED INTERNAL MEDICINE PLLC
Entity Type:Organization
Organization Name:ALLIED INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DHEERAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-439-6780
Mailing Address - Street 1:PO BOX 39334
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85069-9334
Mailing Address - Country:US
Mailing Address - Phone:602-439-6780
Mailing Address - Fax:602-331-5483
Practice Address - Street 1:6644 E BAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1747
Practice Address - Country:US
Practice Address - Phone:480-321-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty