Dadra Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

46421 Issued in AZ

Legal business name

DADRA MEDICAL PC

Practice address

3706 Highway 95 Ste 101
Bullhead City, AZ 86442-8226

Phone

(928) 201-9286

Fax

(928) 219-4610

NPI assigned

Nov 12, 2014

Last updated

Jun 9, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ihtisham Choudhry, MDNPI 1790985273

Title

Physician

Phone

(928) 201-9286

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, NV2 enrollments

Enrollment records 2

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ihtisham Choudhry, MD

  • Internal Medicine Physician
  • Bullhead City, AZ
  • NPI 1790985273

  NV

  Medicare reassignment NPD Authorized official
• Freeha Afshin Azher, MD

  • Family Medicine Physician
  • Bullhead City, AZ
  • NPI 1447699897
  Medicare reassignment NPD
• Jean Wilkens Sainristil

  • Medical Physician Assistant
  • Brockton, MA
  • NPI 1912658493

  AZ

  Medicare reassignment NPD
• Nina C Chase-Bouamoud, P.A.-C

  • Medical Physician Assistant
  • Bullhead City, AZ
  • NPI 1902012966
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1407252844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 HIGHWAY 95 STE 101",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428226",
            "telephone_number": "928-201-9286",
            "fax_number": "928-219-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3706 HIGHWAY 95 STE 101",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428226",
            "telephone_number": "928-201-9286",
            "fax_number": "928-219-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DADRA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "CHOUDHRY",
        "authorized_official_first_name": "IHTISHAM",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "928-201-9286",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "46421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott A Crampton, DPM
• Cruhsd
• Robert Currivan
• Dadra Community Care PC
• Dadra Hospital Medicine PC
• Dadra Now Care PC
• Thomas Gary Dallman, M.D.
• Dianna Darland, B.A.
• Lisa Darrah, FNP
• John K Davis, DO

• Internal Medicine Physician in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.