Provider Demographics
NPI:1124246921
Name:ZAVERI, MINESH RAMESH (DO)
Entity type:Individual
Prefix:
First Name:MINESH
Middle Name:RAMESH
Last Name:ZAVERI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 N 24TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-4645
Mailing Address - Country:US
Mailing Address - Phone:602-844-7246
Mailing Address - Fax:602-759-7246
Practice Address - Street 1:1401 N 24TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4645
Practice Address - Country:US
Practice Address - Phone:602-844-7246
Practice Address - Fax:602-759-7246
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4831207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ380967Medicaid
MI556315795OtherBLUE CROSS BLUE SHIELD
MI5178834-11Medicaid
MI5201899-11Medicaid
AZZ236125OtherMEDICARE PTAN