Basic Information
Provider Information
NPI: 1124382973
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NIJJAR
FirstName: YUVRAJ
MiddleName: SINGH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4838 E. BASELINE RD.
Address2: STE. 108
City: MESA
State: AZ
PostalCode: 85206
CountryCode: US
TelephoneNumber: 4809812400
FaxNumber:  
Practice Location
Address1: 1900 N HIGLEY RD
Address2:  
City: GILBERT
State: AZ
PostalCode: 852341604
CountryCode: US
TelephoneNumber: 4805432600
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2012
LastUpdateDate: 09/23/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X54091AZY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home