Healthcare Provider Details

I. General information

NPI: 1639871981
Provider Name (Legal Business Name): MORGAN SHANO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 N DOBSON RD STE D71
CHANDLER AZ
85224-4234
US

IV. Provider business mailing address

595 N DOBSON RD STE D71
CHANDLER AZ
85224-4234
US

V. Phone/Fax

Practice location:
  • Phone: 480-963-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD-001168
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: