Provider Demographics
NPI:1063724748
Name:YOUNAS, AYESHA (MD)
Entity type:Individual
Prefix:DR
First Name:AYESHA
Middle Name:
Last Name:YOUNAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 N ALMA SCHOOL RD STE C104
Mailing Address - Street 2:BETHESDA PEDIATRICS
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2879
Mailing Address - Country:US
Mailing Address - Phone:480-222-6770
Mailing Address - Fax:480-222-6771
Practice Address - Street 1:2175 N ALMA SCHOOL ROAD
Practice Address - Street 2:STE C104
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2879
Practice Address - Country:US
Practice Address - Phone:480-222-6770
Practice Address - Fax:480-222-6771
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD77822080A0000X
AZ49625208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ947237Medicaid