Healthcare Provider Details

I. General information

NPI: 1881033900
Provider Name (Legal Business Name): SATISH K SHARMA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 06/21/2013
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:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number11513
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number11513
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number11513
License Number StateNV

VIII. Authorized Official

Name: DR. SATISH K SHARMA
Title or Position: OWNER
Credential: MD
Phone: 702-739-8323