Provider Demographics
NPI:1871840108
Name:NAGRE, SANDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:
Last Name:NAGRE
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 1:6644 E BAYWOOD AVE
Mailing Address - Street 2:BANNER BAYWOOD MEDICAL CENTER
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206
Mailing Address - Country:US
Mailing Address - Phone:480-321-3900
Mailing Address - Fax:480-321-3840
Practice Address - Street 1:6644 E BAYWOOD AVE
Practice Address - Street 2:BANNER BAYWOOD MEDICAL CENTER
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-321-3900
Practice Address - Fax:480-321-3840
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.020796207R00000X
AZ50864208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine