=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083896211
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERT G SAIDE MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2007
-----------------------------------------------------
Last Update Date | 11/29/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1728 W GLENDALE AVE SUITE 301
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85021-8860
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-249-1972
-----------------------------------------------------
Fax | 602-433-2199
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1728 W GLENDALE AVE SUITE 301
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85021-8860
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-249-1972
-----------------------------------------------------
Fax | 602-433-2199
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ROBERT G SAIDE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 602-249-1972
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 11627
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------