Healthcare Provider Details

I. General information

NPI: 1225160500
Provider Name (Legal Business Name): SATISH SHARMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5375 S FORT APACHE RD STE 102
LAS VEGAS NV
89148-7623
US

IV. Provider business mailing address

5375 S FORT APACHE RD STE 102
LAS VEGAS NV
89148-7623
US

V. Phone/Fax

Practice location:
  • Phone: 702-739-8323
  • Fax: 702-736-1284
Mailing address:
  • Phone: 702-739-8323
  • Fax: 702-736-1284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2000405-650
License Number StateNV

VIII. Authorized Official

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