Provider Demographics
NPI:1457515579
Name:MADHURI DHUPATI & ASSOCIATES MD PC.
Entity Type:Organization
Organization Name:MADHURI DHUPATI & ASSOCIATES MD PC.
Other - Org Name:PARKVIEW INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-319-8865
Mailing Address - Street 1:PO BOX 8720
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-0128
Mailing Address - Country:US
Mailing Address - Phone:623-544-1700
Mailing Address - Fax:623-544-7544
Practice Address - Street 1:12647 W SMOKEY DR STE 119
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378
Practice Address - Country:US
Practice Address - Phone:623-544-1700
Practice Address - Fax:623-544-7544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25819207R00000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609834928OtherINDIVIDUAL NPI
Z29699Medicare PIN
AZZ29699Medicare UPIN