Provider Demographics
NPI:1295976538
Name:KLEIN, SHAYNA CAROLINE (MD)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:CAROLINE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAYNA
Other - Middle Name:CAROLINE
Other - Last Name:ROBERTS & ROBERTS-KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2323 W ROSE GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-2530
Mailing Address - Country:US
Mailing Address - Phone:602-521-6252
Mailing Address - Fax:623-842-5640
Practice Address - Street 1:10401 W THUNDERBIRD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3004
Practice Address - Country:US
Practice Address - Phone:623-832-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ450442085U0001X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1295976538OtherPHYSICIAN INDIVIDUAL NPI
AZ1841261989OtherGROUP NPI
AZ628578Medicaid
AZZWCBBMOtherGROUP MEDICARE ID
AZCS7943OtherGROUP MEDICARE RAILROAD ID & PTAN
AZ005472OtherGROUP MEDICAID ID
AZP01038305OtherPHYSICIAN MEDICARE RAILROAD ID
AZ1841261989OtherGROUP NPI