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General NPI Number Information
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NPI Number | 1073791810
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Entity Type | Organization
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Legal Business Name | SHELLEY K. NAKAMURA,MD, PLLC
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 4727 E BELL RD STE 45-411
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City | PHOENIX
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State | AZ
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Zip | 85032-2308
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Country | US
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Telephone | 602-568-2050
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Fax | 480-588-8353
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Provider Business Mailing Address
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Address Line | 4727 E BELL RD STE 45-411
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City | PHOENIX
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State | AZ
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Zip | 85032-2308
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Country | US
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Telephone | 602-568-2050
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Fax | 480-588-8353
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Authorized Official
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Title or Position | OWNER
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Name | SHELLEY K NAKAMURA
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Credential | MD
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Telephone | 602-568-2050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 30690
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License Number State | AZ
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