Provider Demographics
NPI:1548229925
Name:SADO, ANTHONY S (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:S
Last Name:SADO
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 1:3749 E CASSIA LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-0464
Mailing Address - Country:US
Mailing Address - Phone:509-430-7597
Mailing Address - Fax:480-626-8437
Practice Address - Street 1:3749 E CASSIA LN
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-0464
Practice Address - Country:US
Practice Address - Phone:509-430-7597
Practice Address - Fax:480-626-8437
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021924207RC0200X
VA0101227824207RC0200X
MO2012037641207RC0200X
CODR44522207RC0200X
OK29461207RC0200X
KS0436090207RC0200X
ARE7784207RC0200X
SC36119207RC0200X
AZ35294207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB33323Medicare ID - Type UnspecifiedPROVIDER NUMBER
AZZ144608Medicare PIN
WAH54408Medicare UPIN
AZZ147334Medicare PIN