=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881033900
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SATISH K SHARMA MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2013
-----------------------------------------------------
Last Update Date | 06/21/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9029 S PECOS RD SUITE 2800
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89074-7197
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-739-8323
-----------------------------------------------------
Fax | 702-739-8605
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 30516 DEPT 9102
-----------------------------------------------------
City | LANSING
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48909-8016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-739-8323
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. SATISH K SHARMA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 702-739-8323
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | 11513
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208VP0014X
-----------------------------------------------------
Taxonomy Name | Interventional Pain Medicine Physician
-----------------------------------------------------
License Number | 11513
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208VP0000X
-----------------------------------------------------
Taxonomy Name | Pain Medicine Physician
-----------------------------------------------------
License Number | 11513
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------