Provider Demographics
NPI:1871553982
Name:CHINIKHANWALA, BURHAN F (MD)
Entity type:Individual
Prefix:
First Name:BURHAN
Middle Name:F
Last Name:CHINIKHANWALA
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 1:3003 HIWAY 95
Mailing Address - Street 2:STE 100
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-7860
Mailing Address - Country:US
Mailing Address - Phone:928-704-5400
Mailing Address - Fax:928-704-5411
Practice Address - Street 1:3003 HIWAY 95
Practice Address - Street 2:STE 100
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7860
Practice Address - Country:US
Practice Address - Phone:928-704-5400
Practice Address - Fax:928-704-5411
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28160207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H13318Medicare UPIN
AZZ107791Medicare PIN
NVV32906Medicare PIN