Provider Demographics
NPI:1265496665
Name:PREMKUMAR, ARCOT S (MD)
Entity type:Individual
Prefix:
First Name:ARCOT
Middle Name:S
Last Name:PREMKUMAR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 18892
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4083
Mailing Address - Country:US
Mailing Address - Phone:888-402-7256
Mailing Address - Fax:888-902-1099
Practice Address - Street 1:2777 E CAMELBACK RD STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4352
Practice Address - Country:US
Practice Address - Phone:602-952-0002
Practice Address - Fax:602-224-9119
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2025-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ12870207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
D37472Medicare UPIN