MEDICARE: SCOTTSDALE CENTER FOR UROLOGY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1225100928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTTSDALE CENTER FOR UROLOGY PLLC

Provider Business Mailing Address
First Line	:	9590 E IRONWOOD SQUARE DR STE 125
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4583
Country	:	US
Telephone Number	:	480-272-6400
Fax Number	:	480-272-6351

Provider Business Practice Location Address
First Line	:	9590 E IRONWOOD SQUARE DR STE 125
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4583
Country	:	US
Telephone Number	:	480-272-6400
Fax Number	:	480-272-6351

Authorized Official
Title or Position	:	PARTNER
Name	:	ROBERT HARRIS SHAPIRO
Credential	:	MD
Telephone Number	:	480-272-6400

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	08/22/2020

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