Healthcare Provider Details

I. General information

NPI: 1053028639
Provider Name (Legal Business Name): DESERT ORTHOPEDICS CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 W UNION HILLS DR STE 1400B
GLENDALE AZ
85308-1061
US

IV. Provider business mailing address

7301 E 2ND ST STE 310
SCOTTSDALE AZ
85251-5627
US

V. Phone/Fax

Practice location:
  • Phone: 877-821-4657
  • Fax: 866-207-6786
Mailing address:
  • Phone: 877-821-4657
  • Fax: 866-207-6786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DR. SARIM SHAKEEL AHMED
Title or Position: CEO
Credential: MD
Phone: 877-821-4657