MEDICARE: SHELLEY K NAKAMURA MD 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	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1992982102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELLEY K NAKAMURA MD PLLC

Provider Business Mailing Address
First Line	:	4727 E BELL RD
Second Line	:	SUITE 45-411
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2308
Country	:	US
Telephone Number	:	480-545-2610
Fax Number	:	480-545-2673

Provider Business Practice Location Address
First Line	:	4727 E BELL RD
Second Line	:	SUITE 45-411
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2308
Country	:	US
Telephone Number	:	480-545-2610
Fax Number	:	480-545-2673

Authorized Official
Title or Position	:	OWNER
Name	:	SHELLY KIMIE NAKAMURA
Credential	:	MD
Telephone Number	:	480-545-2610

Provider Enumeration Date	:	01/30/2008
Last Update Date	:	01/30/2008

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