Healthcare Provider Details

I. General information

NPI: 1922209063
Provider Name (Legal Business Name): SHAKEELA WAZEEN BAHADUR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAKEELA WAZEEN MD

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5499
US

IV. Provider business mailing address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5499
US

V. Phone/Fax

Practice location:
  • Phone: 480-301-8000
  • Fax:
Mailing address:
  • Phone: 480-301-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number44418
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number44418
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: