Healthcare Provider Details

I. General information

NPI: 1205113271
Provider Name (Legal Business Name): SHAWN M HOLDEN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2011
Last Update Date: 11/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4441 E MCDOWELL RD SUITE 101
PHOENIX AZ
85008-4503
US

IV. Provider business mailing address

PO BOX 29211
PHOENIX AZ
85038-9211
US

V. Phone/Fax

Practice location:
  • Phone: 602-273-6770
  • Fax: 602-889-0483
Mailing address:
  • Phone: 602-273-6770
  • Fax: 602-889-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAWN M. HOLDEN
Title or Position: SOLE MEMBER
Credential: D.O.
Phone: 602-273-6770