Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 03-739 | AZ |
N | 207QA0401X | Family Doctor - Addiction Medicine | 03739 | AZ |
NPI | 1194807495 |
---|---|
Provider Name | Dr. Ravi Nanik Chandiramani |
First Address | Scottsdale, AZ 85254-5252 |
Second Address | Scottsdale, AZ 85254-5252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 28/09/2017 |