MEDICARE: DR. SAHIB PUREWAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	78045	AZ
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1881396455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAHIB PUREWAL MD

Provider Business Mailing Address
First Line	:	6677 W THUNDERBIRD RD STE I164
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-3762
Country	:	US
Telephone Number	:	623-878-2100
Fax Number	:	623-776-9419

Provider Business Practice Location Address
First Line	:	2300 PATTERSON ST
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-1538
Country	:	US
Telephone Number	:	615-342-3966
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	01/28/2026

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