Healthcare Provider Details

I. General information

NPI: 1730169319
Provider Name (Legal Business Name): SATISH KUMAR SHARMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 05/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9029 S PECOS RD SUITE 2800
HENDERSON NV
89074-7197
US

IV. Provider business mailing address

PO BOX 30516 DEPT 9102
LANSING MI
48909-8016
US

V. Phone/Fax

Practice location:
  • Phone: 702-739-8323
  • Fax: 702-739-8605
Mailing address:
  • Phone: 702-739-8323
  • Fax: 702-739-8605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number11513
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: