Provider Demographics
NPI:1164452116
Name:TIWARI-SHARMA, PRAGYA (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAGYA
Middle Name:
Last Name:TIWARI-SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PRAGYA
Other - Middle Name:
Other - Last Name:TIWARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:645 E MISSOURI AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1351
Mailing Address - Country:US
Mailing Address - Phone:602-262-8917
Mailing Address - Fax:602-262-8890
Practice Address - Street 1:1500 S DOBSON RD
Practice Address - Street 2:STE: 203
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4713
Practice Address - Country:US
Practice Address - Phone:480-844-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34242207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology