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1114216041

NPI Code Detail

MEDICARE: SIDDHARTH DAVE MD

MEDICARE: SIDDHARTH DAVE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	Q8866	TX
2	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	Q8866	TX
3	207L00000X	Anesthesiology Physician	78292	AZ
4	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	78292	AZ

General Provider Information

NPI Number	:	1114216041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIDDHARTH DAVE MD

Provider Business Mailing Address
First Line	:	2929 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-8034
Country	:	US
Telephone Number	:	602-470-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 E ROOSEVELT ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-4973
Country	:	US
Telephone Number	:	602-344-5039
Fax Number	:	602-344-0779

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2011
Last Update Date	:	12/01/2025

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Directions to “ SIDDHARTH DAVE MD” Practice Location

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