Healthcare Provider Details

I. General information

NPI: 1588008080
Provider Name (Legal Business Name): SUBIN SHARMA M D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2013
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 E ELWOOD ST STE 500
PHOENIX AZ
85040-1978
US

IV. Provider business mailing address

4605 E ELWOOD ST STE 500
PHOENIX AZ
85040-1978
US

V. Phone/Fax

Practice location:
  • Phone: 469-998-7415
  • Fax:
Mailing address:
  • Phone: 469-998-7415
  • 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 Code207L00000X
TaxonomyAnesthesiology Physician
License Number80353
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: