Provider Demographics
NPI:1821602715
Name:SHEITELMAN MEDICAL GLENDALE
Entity Type:Organization
Organization Name:SHEITELMAN MEDICAL GLENDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEITELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-214-7600
Mailing Address - Street 1:5128 W PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-1618
Mailing Address - Country:US
Mailing Address - Phone:623-214-7600
Mailing Address - Fax:623-614-7662
Practice Address - Street 1:5128 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-1618
Practice Address - Country:US
Practice Address - Phone:623-214-7600
Practice Address - Fax:623-614-7662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty