Provider Demographics
NPI:1720248826
Name:REZA ARYAI ROD MD PLLC
Entity Type:Organization
Organization Name:REZA ARYAI ROD MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:REZA
Authorized Official - Middle Name:ARYAI
Authorized Official - Last Name:ROD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:608-217-6567
Mailing Address - Street 1:3815 E BELL RD
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2122
Mailing Address - Country:US
Mailing Address - Phone:602-931-4689
Mailing Address - Fax:
Practice Address - Street 1:3815 E BELL RD
Practice Address - Street 2:SUITE 2200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2122
Practice Address - Country:US
Practice Address - Phone:602-931-4689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ38069208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty