Healthcare Provider Details

I. General information

NPI: 1508139429
Provider Name (Legal Business Name): SHEITELMAN MEDICAL PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2012
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13757 W. BELL RD SUITE 101
SURPRISE AZ
85374-2453
US

IV. Provider business mailing address

13757 W BELL RD SUITE 101
SURPRISE AZ
85374-2452
US

V. Phone/Fax

Practice location:
  • Phone: 623-214-7600
  • Fax: 623-214-7662
Mailing address:
  • Phone: 623-214-7600
  • Fax: 623-214-7662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID A SHEITELMAN
Title or Position: MANAGER
Credential:
Phone: 623-214-7600