Provider Demographics
NPI:1295103299
Name:PEDAPATI, SHILPA (MD)
Entity type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:
Last Name:PEDAPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 E CAMELBACK RD STE 180
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2396
Mailing Address - Country:US
Mailing Address - Phone:602-759-6883
Mailing Address - Fax:602-244-3358
Practice Address - Street 1:5750 W THUNDERBIRD RD STE F680
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4693
Practice Address - Country:US
Practice Address - Phone:602-843-7171
Practice Address - Fax:602-843-5909
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56245207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology