Healthcare Provider Details

I. General information

NPI: 1164876652
Provider Name (Legal Business Name): KARAN SUD M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 E MCDOWELL RD FL 4
PHOENIX AZ
85006-2506
US

IV. Provider business mailing address

755 E MCDOWELL RD FL 4
PHOENIX AZ
85006-2506
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-3090
  • Fax:
Mailing address:
  • Phone: 602-521-3090
  • Fax:

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 Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number81147
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: