Provider Demographics
NPI:1558324640
Name:DREWEK, RUPALI (MD)
Entity Type:Individual
Prefix:DR
First Name:RUPALI
Middle Name:
Last Name:DREWEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RUPALI
Other - Middle Name:
Other - Last Name:BANSAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1919 E THOMAS RD
Mailing Address - Street 2:BLDG 2108, SUITE 101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7710
Mailing Address - Country:US
Mailing Address - Phone:602-512-8029
Mailing Address - Fax:602-512-8161
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:602-933-0985
Practice Address - Fax:602-933-0323
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15528R208000000X
WI49819208000000X, 207RP1001X
AZ373402080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA15528ROtherMEDICAL LICENSE
AZ37340OtherAZ BOARD OF MEDICAL EXAM