Healthcare Provider Details

I. General information

NPI: 1982613097
Provider Name (Legal Business Name): SYED K SHAHRYAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 N 2ND ST SUITE 300
PHOENIX AZ
85012-2368
US

IV. Provider business mailing address

3330 N 2ND ST SUITE 300
PHOENIX AZ
85012-2368
US

V. Phone/Fax

Practice location:
  • Phone: 602-261-7830
  • Fax: 602-261-7835
Mailing address:
  • Phone: 602-261-7830
  • Fax: 602-261-7835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number27038
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number27038
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number27038
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: