Dadra Community Care Pc | |
3706 Highway 95 Ste 101 Bullhead City AZ 86442-8226 | |
(928) 201-9286 | |
(928) 219-4610 |
Full Name | Dadra Community Care Pc |
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Speciality | Internal Medicine |
Location | 3706 Highway 95 Ste 101, Bullhead City, Arizona |
Authorized Official Name and Position | Ihtisham Choudhry (MEDICAL DIRECTOR / OWNER) |
Authorized Official Contact | 7029019001 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dadra Community Care Pc 3706 Highway 95 Ste 101 Bullhead City AZ 86442-8226 Ph: (928) 201-9286 | Dadra Community Care Pc 3706 Highway 95 Ste 101 Bullhead City AZ 86442-8226 Ph: (928) 201-9286 |
NPI Number | 1114657517 |
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Provider Enumeration Date | 06/16/2022 |
Last Update Date | 09/02/2022 |
Medicare PECOS PAC ID | 4981073509 |
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Medicare Enrollment ID | O20221202002485 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114657517 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Ihtisham Choudhry |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1790985273 PECOS PAC ID: 4385831437 Enrollment ID: I20121206000344 |
Provider Name | Freeha A Azher |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1447699897 PECOS PAC ID: 8527340736 Enrollment ID: I20180212000931 |
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