Provider Demographics
NPI:1851622112
Name:DORAISWAMY, VIJAY ARUN (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:ARUN
Last Name:DORAISWAMY
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6567 E CARONDELET DR STE 225
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-6154
Mailing Address - Country:US
Mailing Address - Phone:520-886-3432
Mailing Address - Fax:
Practice Address - Street 1:6567 E CARONDELET DR STE 225
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710
Practice Address - Country:US
Practice Address - Phone:520-886-3432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43424207R00000X, 207RC0000X, 207RI0011X
AZR71082207R00000X
MN62312207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease