Provider Demographics
NPI:1437313723
Name:SANKAR, NARENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:NARENDRA
Middle Name:
Last Name:SANKAR
Suffix:
Gender:M
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:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:DEWEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86327-1568
Mailing Address - Country:US
Mailing Address - Phone:928-632-5291
Mailing Address - Fax:928-632-5447
Practice Address - Street 1:390 S HIGHWAY 69
Practice Address - Street 2:SUITE 102
Practice Address - City:DEWEY
Practice Address - State:AZ
Practice Address - Zip Code:86327-7082
Practice Address - Country:US
Practice Address - Phone:928-632-5291
Practice Address - Fax:928-632-5447
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2015-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ45041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ624416Medicaid
AZZ178249Medicare Oscar/Certification
AZZ147494Medicare Oscar/Certification