Healthcare Provider Details

I. General information

NPI: 1457963894
Provider Name (Legal Business Name): ARIZONA SURGICAL AFFILIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ARIZONA SURGICAL AFFILIATES PLLC 2222 E HIGHLAND AVE, SUITE 222
PHOENIX AZ
85016-4876
US

IV. Provider business mailing address

8402 E SHEA BLVD STE 100
SCOTTSDALE AZ
85260-6635
US

V. Phone/Fax

Practice location:
  • Phone: 602-975-0123
  • Fax:
Mailing address:
  • Phone: 602-975-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: ABHISHIEK SHARMA
Title or Position: MEMBER
Credential: MD
Phone: 602-975-0123