Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 57781 | AZ |
Y | 207RP1001X | Pulmonary Disease | 57781 | AZ |
NPI | 1033478268 |
---|---|
Provider Name | Dr. Ala Eddin Samir Sagar |
First Address | Gilbert, AZ 85234 |
Second Address | Gilbert, AZ 85234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2012 |
Last Update Date | 03/01/2020 |