Provider Demographics
NPI:1710372966
Name:CHARKHZARRIN, SAHBA
Entity Type:Individual
Prefix:
First Name:SAHBA
Middle Name:
Last Name:CHARKHZARRIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1116
Mailing Address - Country:US
Mailing Address - Phone:765-932-4111
Mailing Address - Fax:
Practice Address - Street 1:1310 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1116
Practice Address - Country:US
Practice Address - Phone:765-932-7600
Practice Address - Fax:765-932-7609
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-04
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01079872A207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine