Provider Demographics
NPI:1689609166
Name:NARA, VENKATESH (MD)
Entity Type:Individual
Prefix:
First Name:VENKATESH
Middle Name:
Last Name:NARA
Suffix:
Gender:M
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:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252-0160
Mailing Address - Country:US
Mailing Address - Phone:480-272-8411
Mailing Address - Fax:480-361-1435
Practice Address - Street 1:77 CALLE PORTAL
Practice Address - Street 2:SUITE B260A
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2967
Practice Address - Country:US
Practice Address - Phone:520-515-9751
Practice Address - Fax:520-515-9786
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32171207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZI02428OtherUPIN
AZZ101143Medicare PIN