Provider Demographics
NPI:1215371125
Name:SAINI, SHAWNJEET S (MD)
Entity type:Individual
Prefix:
First Name:SHAWNJEET
Middle Name:S
Last Name:SAINI
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:PO BOX 29025
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038-9025
Mailing Address - Country:US
Mailing Address - Phone:623-328-9704
Mailing Address - Fax:623-888-8570
Practice Address - Street 1:20045 N. 19TH AVENUE
Practice Address - Street 2:BLDG 10, SUITE 3
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027
Practice Address - Country:US
Practice Address - Phone:480-626-2552
Practice Address - Fax:480-626-2551
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3202207L00000X, 207LP2900X
AZ56420207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX375725401Medicaid
TX375725402OtherCSHCN
AZ399166Medicaid