Healthcare Provider Details

I. General information

NPI: 1386058055
Provider Name (Legal Business Name): SASHA HAKMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2014
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9817 N 95TH ST STE 107
SCOTTSDALE AZ
85258-4587
US

IV. Provider business mailing address

26400 W 12 MILE RD # UNITE140
SOUTHFIELD MI
48034-1700
US

V. Phone/Fax

Practice location:
  • Phone: 602-725-2229
  • Fax:
Mailing address:
  • Phone: 866-258-8467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301503765
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number66428
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number4301503765
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: