Provider Demographics
NPI:1558477984
Name:SAHNI, MANISH (MD)
Entity Type:Individual
Prefix:DR
First Name:MANISH
Middle Name:
Last Name:SAHNI
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 1:13000 N 103RD AVE
Mailing Address - Street 2:STE 59
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3024
Mailing Address - Country:US
Mailing Address - Phone:623-594-4126
Mailing Address - Fax:623-594-4127
Practice Address - Street 1:13000 N 103RD AVE
Practice Address - Street 2:STE 59
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3024
Practice Address - Country:US
Practice Address - Phone:623-594-4126
Practice Address - Fax:623-594-4127
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34926207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ539478Medicaid
AZZ158078Medicare PIN
01080OtherBCBS
I16582Medicare UPIN