Healthcare Provider Details

I. General information

NPI: 1477796209
Provider Name (Legal Business Name): ABHISHIEK SHARMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
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

Practice location:
  • Phone: 602-975-0123
  • Fax:
Mailing address:
  • Phone: 602-975-0123
  • 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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number55226-20
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number52138
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: