Provider Demographics
NPI:1598508731
Name:SS HEALTHCARE PLC
Entity type:Organization
Organization Name:SS HEALTHCARE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIVA
Authorized Official - Middle Name:KUMAR YADAV
Authorized Official - Last Name:GOSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-767-8897
Mailing Address - Street 1:17913 N 66TH WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-6730
Mailing Address - Country:US
Mailing Address - Phone:423-767-8897
Mailing Address - Fax:
Practice Address - Street 1:17913 N 66TH WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-6730
Practice Address - Country:US
Practice Address - Phone:423-767-8897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-15
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty