Provider Demographics
NPI:1528248747
Name:THOSANI, MAYA K (MD, FAAD, FACMS)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:K
Last Name:THOSANI
Suffix:
Gender:F
Credentials:MD, FAAD, FACMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7337 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5603
Mailing Address - Country:US
Mailing Address - Phone:480-712-8741
Mailing Address - Fax:480-712-9518
Practice Address - Street 1:7337 E 2ND ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5603
Practice Address - Country:US
Practice Address - Phone:480-712-8741
Practice Address - Fax:480-712-9518
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49156207ND0101X, 207N00000X
NY237598390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ922719Medicaid
AZ922719Medicaid