Provider Demographics
NPI:1063695591
Name:THOSANI, AMAR JITENDRA (MD)
Entity type:Individual
Prefix:DR
First Name:AMAR
Middle Name:JITENDRA
Last Name:THOSANI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3501 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5648
Mailing Address - Country:US
Mailing Address - Phone:480-424-7228
Mailing Address - Fax:480-424-7317
Practice Address - Street 1:3501 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 320
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5648
Practice Address - Country:US
Practice Address - Phone:480-424-7228
Practice Address - Fax:480-424-7317
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2014-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY60 246893207R00000X
AZ49200207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ910562Medicaid
AZZ169802Medicare PIN