Provider Demographics
NPI:1831167238
Name:KALYA, ANANTHARAM V (MD)
Entity type:Individual
Prefix:
First Name:ANANTHARAM
Middle Name:V
Last Name:KALYA
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 1:1111 E MCDOWELL RD FL 2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2612
Mailing Address - Country:US
Mailing Address - Phone:602-839-9300
Mailing Address - Fax:602-839-2720
Practice Address - Street 1:1111 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2612
Practice Address - Country:US
Practice Address - Phone:602-839-9300
Practice Address - Fax:602-839-2720
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40822207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ416564Medicaid
IN200523330Medicaid
AZP00804330OtherRAILROAD MEDICARE
INF95313Medicare UPIN
IN200523330Medicaid
AZ416564Medicaid
AZZ128694Medicare PIN