Healthcare Provider Details

I. General information

NPI: 1699650044
Provider Name (Legal Business Name): SHANE SPEIRS MD II PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 SOUTHBRIDGE ST
AUBURN MA
01501-1323
US

IV. Provider business mailing address

501 N 44TH ST STE 450
PHOENIX AZ
85008-6526
US

V. Phone/Fax

Practice location:
  • Phone: 602-491-0703
  • Fax: 508-832-6479
Mailing address:
  • Phone: 602-491-0703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. FARAH KHAN
Title or Position: PARTNER
Credential: MD
Phone: 480-495-5485