Healthcare Provider Details
I. General information
NPI: 1679865893
Provider Name (Legal Business Name): SHARON HUGHES GNAGI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/05/2011
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1920 E CAMBRIDGE AVE STE 201
PHOENIX AZ
85006-1462
US
IV. Provider business mailing address
3200 E CAMELBACK RD STE 250
PHOENIX AZ
85018-2327
US
V. Phone/Fax
- Phone: 602-933-3277
- Fax: 602-933-4326
- Phone: 602-933-1813
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207YP0228X |
| Taxonomy | Pediatric Otolaryngology Physician |
| License Number | 39353 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | AZ |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207YP0228X |
| Taxonomy | Pediatric Otolaryngology Physician |
| License Number | 46036 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: