Provider Demographics
NPI:1215821533
Name:KANDASAMY, ANURADHA (MD)
Entity type:Individual
Prefix:
First Name:ANURADHA
Middle Name:
Last Name:KANDASAMY
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 1:16605 E PALISADES BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-3717
Mailing Address - Country:US
Mailing Address - Phone:480-837-4300
Mailing Address - Fax:
Practice Address - Street 1:16605 E PALISADES BLVD STE 150
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3717
Practice Address - Country:US
Practice Address - Phone:480-837-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR81573207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine