Provider Demographics
NPI:1598997348
Name:DHAKAL, LAXMI P (MD)
Entity type:Individual
Prefix:
First Name:LAXMI
Middle Name:P
Last Name:DHAKAL
Suffix:
Gender:M
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:PO BOX 20610
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85277-0610
Mailing Address - Country:US
Mailing Address - Phone:833-723-4410
Mailing Address - Fax:210-695-7714
Practice Address - Street 1:3719 E LOUISE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-8314
Practice Address - Country:US
Practice Address - Phone:480-985-1093
Practice Address - Fax:480-296-7665
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0438053207RC0200X
WI1196207RC0200X, 2084N0400X
LA3347082084A2900X, 2084N0400X
AZ681622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care