Provider Demographics
NPI:1558548735
Name:SHAH, DEEPESH M (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPESH
Middle Name:M
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13430 N SCOTTSDALE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4058
Mailing Address - Country:US
Mailing Address - Phone:623-334-4000
Mailing Address - Fax:623-334-4400
Practice Address - Street 1:16390 N 59TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306
Practice Address - Country:US
Practice Address - Phone:623-334-4000
Practice Address - Fax:623-334-4400
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
37959174400000X
MAL-225536207L00000X
AZ37959207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No174400000XOther Service ProvidersSpecialist
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology