Provider Demographics
NPI:1811947898
Name:GANDHY, MEERA P (MD)
Entity type:Individual
Prefix:MS
First Name:MEERA
Middle Name:P
Last Name:GANDHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11277 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-7298
Mailing Address - Country:US
Mailing Address - Phone:928-341-0335
Mailing Address - Fax:
Practice Address - Street 1:3220 E 40TH ST
Practice Address - Street 2:THE EXCEL GROUP
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-7748
Practice Address - Country:US
Practice Address - Phone:928-341-0335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ320912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ816035OtherAHCCCS #
AZ77294Medicare ID - Type Unspecified
AZ816035OtherAHCCCS #
AZ77296Medicare ID - Type Unspecified
AZZ77296Medicare PIN
D14111Medicare UPIN