Provider Demographics
NPI:1275736829
Name:AJAY NARWANI MD PLLC
Entity Type:Organization
Organization Name:AJAY NARWANI MD PLLC
Other - Org Name:SPECIALTY PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PAIN MANAGEMENT DOCTOR/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:MOHAN
Authorized Official - Last Name:NARWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-496-2699
Mailing Address - Street 1:1466 W ELLIOT RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5186
Mailing Address - Country:US
Mailing Address - Phone:480-496-2699
Mailing Address - Fax:877-422-3184
Practice Address - Street 1:1466 W ELLIOT RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5186
Practice Address - Country:US
Practice Address - Phone:480-496-2699
Practice Address - Fax:877-422-3184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35814207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ199555Medicaid
AZ199555Medicaid
AZZ118591Medicare PIN