Provider Demographics
NPI:1528031648
Name:KRISHNA PILLAI, MANJU (MD)
Entity Type:Individual
Prefix:DR
First Name:MANJU
Middle Name:
Last Name:KRISHNA PILLAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MANJU
Other - Middle Name:KRISHNA
Other - Last Name:PILLAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1343 N ALMA SCHOOL RD
Mailing Address - Street 2:STE 160
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224
Mailing Address - Country:US
Mailing Address - Phone:480-963-1853
Mailing Address - Fax:480-726-0695
Practice Address - Street 1:1343 N ALMA SCHOOL RD
Practice Address - Street 2:STE 160
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-963-1853
Practice Address - Fax:480-726-0695
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34566207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ985286Medicaid
AZ985286Medicaid