Provider Demographics
NPI:1881037539
Name:GHOSE KUNDU, RIA (MD)
Entity Type:Individual
Prefix:DR
First Name:RIA
Middle Name:
Last Name:GHOSE KUNDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RIA
Other - Middle Name:
Other - Last Name:KUNDU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20745 N SCOTTSDALE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6595
Mailing Address - Country:US
Mailing Address - Phone:480-882-7510
Mailing Address - Fax:480-946-3711
Practice Address - Street 1:6644 E BAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1747
Practice Address - Country:US
Practice Address - Phone:480-321-3844
Practice Address - Fax:480-321-3840
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ52476208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program