Provider Demographics
NPI:1457556102
Name:STIMSONRIAHI, AVISHEH (MD)
Entity Type:Individual
Prefix:DR
First Name:AVISHEH
Middle Name:
Last Name:STIMSONRIAHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AVISHEH
Other - Middle Name:MATBOO
Other - Last Name:RIAHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9225 N 3RD ST
Mailing Address - Street 2:STE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2466
Mailing Address - Country:US
Mailing Address - Phone:602-445-0751
Mailing Address - Fax:602-424-8128
Practice Address - Street 1:9225 N 3RD ST
Practice Address - Street 2:STE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2466
Practice Address - Country:US
Practice Address - Phone:602-445-0751
Practice Address - Fax:602-424-8128
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44529207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics