Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 28596 | AZ |
N | 2080N0001X | Neonatal-Perinatal Doctor | 28596 | AZ |
NPI | 1053341131 |
---|---|
Provider Name | Sarvesh K Nigam |
First Address | Phoenix, AZ 85013-3420 |
Second Address | Phoenix, AZ 85013-3420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
537988 | (05) | AZ |