Provider Demographics
NPI:1477789170
Name:SAGUARO INTERNAL MEDICINE, PLLC
Entity Type:Organization
Organization Name:SAGUARO INTERNAL MEDICINE, PLLC
Other - Org Name:SAGUARO INTERNAL MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:SATYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-546-0007
Mailing Address - Street 1:14506 W GRANITE VALLEY DR
Mailing Address - Street 2:STE 225
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-6010
Mailing Address - Country:US
Mailing Address - Phone:623-546-0007
Mailing Address - Fax:623-584-6915
Practice Address - Street 1:14506 W GRANITE VALLEY DR
Practice Address - Street 2:STE 225
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-6010
Practice Address - Country:US
Practice Address - Phone:623-546-0007
Practice Address - Fax:623-584-6915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-09
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMD22681207R00000X, 261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ179342Medicaid
AZAZ0382500OtherBLUE CROSS
AZ179342Medicaid