Provider Demographics
NPI:1699778225
Name:SWAMINATHAN, ARIV (MD)
Entity type:Individual
Prefix:DR
First Name:ARIV
Middle Name:
Last Name:SWAMINATHAN
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 1:3333 E CAMELBACK RD
Mailing Address - Street 2:STE 180
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2322
Mailing Address - Country:US
Mailing Address - Phone:602-997-0484
Mailing Address - Fax:602-224-3315
Practice Address - Street 1:5750 W THUNDERBIRD RD STE F680
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4693
Practice Address - Country:US
Practice Address - Phone:602-843-7171
Practice Address - Fax:602-843-5909
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21976207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ180258Medicaid
AZ180258Medicaid
AZ28495Medicare PIN