NPI 1073778064 · live from the CMS NPI Registry
Prathab Devaraj, MD
Internal Medicine in Gilbert, AZ. National Provider Identifier 1073778064, active.
NPI record
| NPI | 1073778064 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine 207R00000X |
| Practice location | 2946 E Banner Gateway Dr, Gilbert, AZ 85234 |
| Practice phone | 480-256-6444 |
| Enumerated | July 19, 2008 |
| Last updated | October 31, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine | 207R00000X | MD443519 (PA) |
| Internal Medicine, Gastroenterology | 207RG0100X | 46888 (AZ) |
| Internal Medicine primary | 207R00000X | 46888 (AZ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.