Healthcare Provider Details

I. General information

NPI: 1316505977
Provider Name (Legal Business Name): SCOTTSDALE PULMONARY AND CRITICAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 E. 2ND ST. SUITE 315
SCOTTSDALE AZ
85251
US

IV. Provider business mailing address

7301 E. 2ND ST. SUITE 315
SCOTTSDALE AZ
85251
US

V. Phone/Fax

Practice location:
  • Phone: 480-994-9838
  • Fax: 480-994-5811
Mailing address:
  • Phone: 480-994-9838
  • Fax: 480-994-5811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALPA P. SHAH
Title or Position: DIRECTOR/PHYSICIAN
Credential: M.D.
Phone: 480-994-9838