Provider Demographics
NPI:1265103576
Name:PVD MEDICAL PLLC
Entity type:Organization
Organization Name:PVD MEDICAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRANAV
Authorized Official - Middle Name:VIKRAM
Authorized Official - Last Name:DOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-922-1020
Mailing Address - Street 1:10240 W INDIAN SCHOOL RD STE 140
Mailing Address - Street 2:
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 STE 140
Practice Address - Street 2:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-26
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty