Provider Demographics
NPI:1356419410
Name:SHPITALNIK, ZHANNA F (MD)
Entity type:Individual
Prefix:
First Name:ZHANNA
Middle Name:F
Last Name:SHPITALNIK
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 1:560 W BROWN RD
Mailing Address - Street 2:#4007
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-3221
Mailing Address - Country:US
Mailing Address - Phone:602-470-5520
Mailing Address - Fax:480-649-0783
Practice Address - Street 1:560 W BROWN RD
Practice Address - Street 2:#4007
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-3221
Practice Address - Country:US
Practice Address - Phone:602-470-5520
Practice Address - Fax:480-649-0783
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ288562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ573487Medicaid
AZ573487Medicaid
AZH46183Medicare UPIN