Provider Demographics
NPI:1285310581
Name:SERVE MD LLC
Entity type:Organization
Organization Name:SERVE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAGHAV
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHINDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-493-9937
Mailing Address - Street 1:7900 E FLORENTINE RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-2218
Mailing Address - Country:US
Mailing Address - Phone:928-493-9937
Mailing Address - Fax:928-304-7770
Practice Address - Street 1:7900 E FLORENTINE RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2218
Practice Address - Country:US
Practice Address - Phone:928-493-9937
Practice Address - Fax:928-304-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty