Basic Information
| Provider Information | |||||||||
| NPI: | 1184885659 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASKARI | ||||||||
| FirstName: | SHAHRAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.P.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 838 W ELLIOT RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852335162 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803747354 | ||||||||
| FaxNumber: | 4804648287 | ||||||||
| Practice Location | |||||||||
| Address1: | 10214 N TATUM BLVD STE B300 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850284233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6029540777 | ||||||||
| FaxNumber: | 6029546843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2008 | ||||||||
| LastUpdateDate: | 08/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 0679 | AZ | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
ID Information
| ID | Type | State | Issuer | Description | 348925 | 05 | AZ | MEDICAID |