Provider Demographics
NPI:1306871892
Name:SABA, RADWAN (MD)
Entity type:Individual
Prefix:
First Name:RADWAN
Middle Name:
Last Name:SABA
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 13385
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-3385
Mailing Address - Country:US
Mailing Address - Phone:480-609-9300
Mailing Address - Fax:480-609-9350
Practice Address - Street 1:3533 CANYON DE FLORES
Practice Address - Street 2:SUITE A
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85650-5366
Practice Address - Country:US
Practice Address - Phone:520-515-9751
Practice Address - Fax:520-515-9786
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29030207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ549701Medicaid
AZP01260568Medicare PIN
AZG33450Medicare UPIN
AZZ64748Medicare PIN
AZ549701Medicaid