Provider Demographics
NPI:1609036268
Name:SAADAT, SHARAREH (MD)
Entity Type:Individual
Prefix:
First Name:SHARAREH
Middle Name:
Last Name:SAADAT
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 1:7328 E VISTA BONITA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4992
Mailing Address - Country:US
Mailing Address - Phone:602-708-1377
Mailing Address - Fax:
Practice Address - Street 1:6622 N 91ST AVE STE 200
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-2569
Practice Address - Country:US
Practice Address - Phone:623-547-4668
Practice Address - Fax:623-535-7869
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ45284207RN0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ702012Medicaid
AZR70176OtherTRAINING PERMIT