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Contact Information

KELLI R FAVATA, MD
3530 S VAL VISTA DR STE B210
GILBERT, AZ85297-7318
 Phone: 800-991-6117
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Specialist

246XC2903X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KELLI R FAVATA · (Female)

NPI # 1184822348
Status Active
Credentials MD
Entity Individual
Enumeration date 07/10/2007
Last updated 02/15/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • AZ License # 45344
  • SC License # 30177
  • AZ Medicaid 654974
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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