Provider Demographics
NPI:1801840384
Name:SAHASRABUDHE, AMIT A (MD PC)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:A
Last Name:SAHASRABUDHE
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8630 E VIA DE VENTURA
Mailing Address - Street 2:STE 105
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3358
Mailing Address - Country:US
Mailing Address - Phone:480-889-1838
Mailing Address - Fax:623-777-4593
Practice Address - Street 1:8630 E VIA DE VENTURA
Practice Address - Street 2:STE 105
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3358
Practice Address - Country:US
Practice Address - Phone:480-889-1838
Practice Address - Fax:480-889-1917
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36788207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3Z3949OtherHEALTHNET
AZ340268Medicaid
AZP00845806Medicare PIN
AZ340268Medicaid