Healthcare Provider Details

I. General information

NPI: 1891322442
Provider Name (Legal Business Name): HIRRAH SAJJAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 E BROADWAY RD STE 107
MESA AZ
85206-1346
US

IV. Provider business mailing address

5151 E BROADWAY RD STE 107
MESA AZ
85206-1346
US

V. Phone/Fax

Practice location:
  • Phone: 480-290-7000
  • Fax: 480-325-3461
Mailing address:
  • Phone: 480-290-7000
  • Fax: 480-325-3461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number80758
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number1891322442
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: