Provider Demographics
NPI:1275513012
Name:SEARLE, SHAWN L (MD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:L
Last Name:SEARLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 W CHANDLER HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-5055
Mailing Address - Country:US
Mailing Address - Phone:480-726-7546
Mailing Address - Fax:
Practice Address - Street 1:270 W CHANDLER HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-5055
Practice Address - Country:US
Practice Address - Phone:480-726-7546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25539207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ398900Medicaid
AZ20790Medicare ID - Type Unspecified
AZ398900Medicaid