Provider Demographics
NPI:1619983814
Name:SHAIKEWITZ, MICHAEL SCOTT (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SCOTT
Last Name:SHAIKEWITZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3029 N ALMA SCHOOL RD
Mailing Address - Street 2:SUITE #108
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-1477
Mailing Address - Country:US
Mailing Address - Phone:480-831-0334
Mailing Address - Fax:480-897-0351
Practice Address - Street 1:3029 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE #108
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-1477
Practice Address - Country:US
Practice Address - Phone:480-831-0334
Practice Address - Fax:480-897-0351
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T42131Medicare UPIN