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General NPI Number Information
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NPI Number | 1558668715
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Entity Type | Organization
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Legal Business Name | SHEA WOMENS CARE PC
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 05/02/2011
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Provider Practice Location Address
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Address Line | 9522 E SAN SALVADOR DR #319
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5557
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Country | US
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Telephone | 480-767-0010
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Fax | 480-767-0030
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Provider Business Mailing Address
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Address Line | 10105 E VIA LINDA STE 103-282
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5311
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Country | US
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Telephone | 480-767-0010
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Fax | 480-767-0030
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Authorized Official
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Title or Position | MEMBER
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Name | BRENDA A MARTIN
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Credential | MD
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Telephone | 480-767-0010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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