Provider Demographics
NPI:1174503411
Name:MOHTY, MAY (MD)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:
Last Name:MOHTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 E CAMELBACK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2327
Mailing Address - Country:US
Mailing Address - Phone:602-933-1814
Mailing Address - Fax:602-933-1820
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-1900
Practice Address - Fax:602-933-1918
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20459208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ171306Medicaid
AZ67140Medicare ID - Type Unspecified
60795Medicare ID - Type Unspecified
AZ60793Medicare ID - Type Unspecified
AZ60794Medicare ID - Type Unspecified
AZ67139Medicare ID - Type Unspecified
AZ69885Medicare ID - Type Unspecified
AZ24966Medicare ID - Type Unspecified
AZ67141Medicare ID - Type Unspecified
AZ171306Medicaid
AZF18501Medicare UPIN