Basic Information
| Provider Information | |||||||||
| NPI: | 1225160500 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SATISH SHARMA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ADVANCED PAIN MANAGEMENT CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5375 S FORT APACHE RD | ||||||||
| Address2: | STE 102 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891487623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027398323 | ||||||||
| FaxNumber: | 7027361284 | ||||||||
| Practice Location | |||||||||
| Address1: | 5375 S FORT APACHE RD | ||||||||
| Address2: | STE 102 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891487623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027398323 | ||||||||
| FaxNumber: | 7027361284 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SHARMA | ||||||||
| AuthorizedOfficialFirstName: | SATISH | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7027398323 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | 2000405-650 | NV | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1730169319 | 01 | NV | PROVIDER NPI | OTHER |