| East Valley Infectious Disease Medicine Llc | |
|
18637 E Cardinal Way Ste 100a Queen Creek AZ 85142-5546 | |
| (602) 241-0273 | |
| (602) 241-0249 |
| Full Name | East Valley Infectious Disease Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 18637 E Cardinal Way Ste 100a, Queen Creek, Arizona |
| Authorized Official Name and Position | Shashikala Ameneni (PHYSICIAN/OWNER) |
| Authorized Official Contact | 6022410273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Valley Infectious Disease Medicine Llc 18637 E Cardinal Way Ste 100a Queen Creek AZ 85142-5546 Ph: (602) 241-0273 | East Valley Infectious Disease Medicine Llc 18637 E Cardinal Way Ste 100a Queen Creek AZ 85142-5546 Ph: (602) 241-0273 |
| NPI Number | 1508643628 |
|---|---|
| Provider Enumeration Date | 09/12/2023 |
| Last Update Date | 09/18/2023 |
| Medicare PECOS PAC ID | 9739531518 |
|---|---|
| Medicare Enrollment ID | O20240117001919 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508643628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Sunitha Suresh |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1780962431 PECOS PAC ID: 1456342328 Enrollment ID: I20040519001432 |
| Provider Name | Shashikala Ameneni |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346229895 PECOS PAC ID: 4183630650 Enrollment ID: I20060222000109 |
| Provider Name | Hardeep Grewal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669432118 PECOS PAC ID: 9830183334 Enrollment ID: I20060223000239 |
| Provider Name | Joseph Zachariah |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1649293895 PECOS PAC ID: 9133137227 Enrollment ID: I20060331000134 |
| Provider Name | Adonis Jabbour |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1356463160 PECOS PAC ID: 2668563610 Enrollment ID: I20070807000018 |
| Provider Name | Aparajita Singh |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1215020052 PECOS PAC ID: 0042118937 Enrollment ID: I20080825000576 |
| Provider Name | Gauri Chandrakant Barlingay |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1366979700 PECOS PAC ID: 9234529348 Enrollment ID: I20220815003404 |
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Providence Service, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2530 W Allens Peak Dr, Queen Creek, AZ 85142 Phone: 615-668-4485 Fax: 480-812-3131 | |
Banner Copper Basin Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2474 E Hunt Hwy, Suite 10, Queen Creek, AZ 85143 Phone: 480-543-6680 | |
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