Provider Demographics
NPI:1760546162
Name:AMANAT, SHAHIN SEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHIN
Middle Name:SEAN
Last Name:AMANAT
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 1:6112 E AVENIDA DE KIRA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1247
Mailing Address - Country:US
Mailing Address - Phone:520-299-1264
Mailing Address - Fax:
Practice Address - Street 1:1980 W HOSPITAL DR
Practice Address - Street 2:SUITE # 204
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7802
Practice Address - Country:US
Practice Address - Phone:520-547-0433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ339922085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH62032Medicare UPIN