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General NPI Number Information
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NPI Number | 1366726788
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Entity Type | Individual
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Provider Name | VERSHALEE SHUKLA MD
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Gender | Female
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Dates
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Enumeration Date | 10/04/2011
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 7469 E MONTE CRISTO AVE
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-1618
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Country | US
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Telephone | 480-306-5390
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Fax | 480-842-8761
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Provider Business Mailing Address
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Address Line | PO BOX 207429
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City | DALLAS
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State | TX
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Zip | 75320-7429
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Country | US
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Telephone | 480-306-5390
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Fax | 480-842-8761
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 45161
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License Number State | AZ
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