Provider Demographics
NPI:1831153600
Name:DEWANJEE, SUMIT (MD)
Entity type:Individual
Prefix:DR
First Name:SUMIT
Middle Name:
Last Name:DEWANJEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 E 3RD AVE
Mailing Address - Street 2:STE 413
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-4451
Mailing Address - Country:US
Mailing Address - Phone:480-272-7960
Mailing Address - Fax:480-272-7960
Practice Address - Street 1:7301 E 3RD AVE
Practice Address - Street 2:STE 413
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-4451
Practice Address - Country:US
Practice Address - Phone:480-272-7960
Practice Address - Fax:480-272-7960
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32018207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ885999Medicaid
AZ83272Medicare ID - Type UnspecifiedMEDICARE NUMBER
AZ885999Medicaid