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General NPI Number Information
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NPI Number | 1114216041
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Entity Type | Individual
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Provider Name | SIDDHARTH DAVE MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 2601 E ROOSEVELT ST
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City | PHOENIX
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State | AZ
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Zip | 85008-4973
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Country | US
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Telephone | 602-344-5039
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Fax | 602-344-0779
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Provider Business Mailing Address
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Address Line | 2929 E THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85016-8034
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Country | US
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Telephone | 602-470-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | Q8866
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | Q8866
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 78292
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 78292
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License Number State | AZ
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