OrganizationActive
East Valley Infectious Disease Medicine LLC
NPI 1508643628 · Infectious Disease Physician · Mesa, AZ
Provider details
- NPI number
- 1508643628
- Entity type
- Organization
- Primary specialty
- Infectious Disease PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Shashikala Ameneni, Authorized Signer(480) 648-7895
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
6040 E Main St # 516
Mesa, AZ 85205-8928
Phone: (480) 648-7895
Fax: (623) 552-3320
Approximate (ZIP-level) locationGet directions
Mailing address
Evidm Lockbox Dept 880778
Phoenix, AZ 85038-9650
Registry dates
- Enumerated
- 2023-09-12
- Last updated
- 2025-04-23
- Certified
- 2025-04-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.