Provider Demographics
NPI:1013170612
Name:DOSHI, PRANAV V (DO)
Entity Type:Individual
Prefix:DR
First Name:PRANAV
Middle Name:V
Last Name:DOSHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:10240 W INDIAN SCHOOL RD
Mailing Address - Street 2:STE 140
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-5907
Mailing Address - Country:US
Mailing Address - Phone:602-922-1020
Mailing Address - Fax:602-922-1021
Practice Address - Street 1:10240 W INDIAN SCHOOL RD
Practice Address - Street 2:STE 140
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-5907
Practice Address - Country:US
Practice Address - Phone:602-922-1020
Practice Address - Fax:602-922-1021
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ006696207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ024627Medicaid
AZ024627Medicaid