Provider Demographics
NPI:1972721538
Name:PUROHIT, MANISHA AMISH (MD)
Entity Type:Individual
Prefix:DR
First Name:MANISHA
Middle Name:AMISH
Last Name:PUROHIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 E NOLAN PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5504
Mailing Address - Country:US
Mailing Address - Phone:480-529-6124
Mailing Address - Fax:
Practice Address - Street 1:4135 S POWER RD
Practice Address - Street 2:SUITE 113
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-3624
Practice Address - Country:US
Practice Address - Phone:480-257-2700
Practice Address - Fax:480-257-2701
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35870207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology