Healthcare Provider Details
I. General information
NPI: 1467979955
Provider Name (Legal Business Name): ATLAS NEUROSURGERY AND SPINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2017
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8402 E SHEA BLVD STE 100
SCOTTSDALE AZ
85260-6635
US
IV. Provider business mailing address
8402 E SHEA BLVD STE 100
SCOTTSDALE AZ
85260-6635
US
V. Phone/Fax
- Phone: 602-975-0123
- Fax:
- Phone: 602-975-0123
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ABHISHIEK
SHARMA
Title or Position: NEUROSURGEON
Credential: MD
Phone: 602-975-0123