Provider Demographics
NPI:1003286782
Name:CENTERS, SHAWN KRISTIAN (MD(H))
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:KRISTIAN
Last Name:CENTERS
Suffix:
Gender:M
Credentials:MD(H)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 E ALOE PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-3109
Mailing Address - Country:US
Mailing Address - Phone:619-228-5515
Mailing Address - Fax:
Practice Address - Street 1:2442 E ALOE PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-3109
Practice Address - Country:US
Practice Address - Phone:877-614-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7407208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics