Provider Demographics
NPI:1083688253
Name:MURPHY, SHANNAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANNAN
Middle Name:M
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3655 W ANTHEM WAY
Mailing Address - Street 2:SUITE A109 PMB 313
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086
Mailing Address - Country:US
Mailing Address - Phone:623-879-1866
Mailing Address - Fax:623-879-1876
Practice Address - Street 1:19829 N 27TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4001
Practice Address - Country:US
Practice Address - Phone:623-879-1866
Practice Address - Fax:623-879-1876
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ30911207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ30911OtherMEDICAL LICENSE
AZH93068Medicare UPIN