Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 36505 | AZ |
NPI | 1003965278 |
---|---|
Provider Name | Dr. Bindu Jayavelu |
First Address | Tempe, AZ 85284-3494 |
Second Address | Mesa, AZ 85206-5243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 19/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
234662 | (05) | AZ |
I15428 | (02) | MA |
Z148451 | BANNER MD ANDERSON CANCER CENTER (01) | AZ |