Provider Demographics
NPI:1376761577
Name:SAHAI, SHIMUL BANSAL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIMUL
Middle Name:BANSAL
Last Name:SAHAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 N MCQUEEN ROAD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8149
Mailing Address - Country:US
Mailing Address - Phone:480-398-1940
Mailing Address - Fax:480-782-1453
Practice Address - Street 1:963 N MCQUEEN ROAD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8149
Practice Address - Country:US
Practice Address - Phone:480-398-1940
Practice Address - Fax:480-782-1453
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ366712081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ223526Medicaid