Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Chethan Ram Mudiyam, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1609361971

Chethan Ram Mudiyam, MD is an Obstetrics/Gynecology in Phoenix, Arizona. Graduated from University of Toledo College of Medicine in 2018, 8 years ago. Licensed in Arizona.

Years since qualifying
8
Trained at
University of Toledo College of Medicine
Licensed in
AZ
In the registry since
2018
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1441 N 12th St
Phoenix, AZ 85006-2837
Phone: (602) 521-5700
Fax: (602) 521-5701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence R77674 (AZ)

Record details

NPI number1609361971
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 28, 2018
Last updated in NPPESSeptember 4, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolUNIVERSITY OF TOLEDO COLLEGE OF MEDICINE
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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