Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 9652815-1205 | UT |
Y | 207QA0505X | Family Doctor - Adult Medicine | 48027 | AZ |
NPI | 1295046621 |
---|---|
Provider Name | Dr. Philip Maharaj-Prasad |
First Address | Tucson, AZ 85741 |
Second Address | Tucson, AZ 85741-3529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2010 |
Last Update Date | 19/03/2018 |