MEDICARE: VANCE MARTIN ABSHIRE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	32271	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457374290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANCE MARTIN ABSHIRE M.D.

Provider Business Mailing Address
First Line	:	5325 E JACOB WALTZ ST
Second Line	:
City	:	APACHE JUNCTION
State	:	AZ
Zip	:	85119-9450
Country	:	US
Telephone Number	:	480-463-4022
Fax Number	:	480-302-5242

Provider Business Practice Location Address
First Line	:	5325 E JACOB WALTZ ST
Second Line	:
City	:	APACHE JUNCTION
State	:	AZ
Zip	:	85119-9450
Country	:	US
Telephone Number	:	480-463-4022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	05/07/2025

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