MEDICARE: DR. SHEENA SPENCE M.D.

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	208600000X	Surgery Physician	233303	MA
2	207L00000X	Anesthesiology Physician	036128824	IL
3	207L00000X	Anesthesiology Physician	58836	AZ

General Provider Information

NPI Number	:	1902071814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEENA SPENCE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 51071
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85076-1071
Country	:	US
Telephone Number	:	480-809-2920
Fax Number	:

Provider Business Practice Location Address
First Line	:	1398 N WILMOT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5132
Country	:	US
Telephone Number	:	480-809-2920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	04/28/2021

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