| Doctor Name: | DR. VIJAYABHANU MAHADEVAN |
| NPI Number: | 1083727333 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 0101230340 |
| Business Practice Address: | 12665 W Smokey Dr # 140 #140 Surprise, AZ - 853783703 |
| Business Phone Number: | 6232194040 |
| Business Fax Number: | 6232194050 |
| Mailing Address: | 12665 W Smokey Dr # 140, #140 SURPRISE |
| State: | AZ |
| Postal Code: | 853783703 |
| Phone Number: | 6232194040 |
| Fax Number: | 6232194050 |
| NPI Enumeration Date: | 08/17/2006 |
| NPI Last Update Date: | 05/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RR0500X |
| License Number: | 0101230340 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Rheumatology |
| Taxonomy Definition: | An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |