Provider Demographics
NPI:1376630152
Name:KAPLAN, SHELBY MICHAEL (DC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:MICHAEL
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 WEST HAWK WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4558
Mailing Address - Country:US
Mailing Address - Phone:480-657-2636
Mailing Address - Fax:602-840-3718
Practice Address - Street 1:3102 E INDIAN SCHOOL RD
Practice Address - Street 2:SUITE 140
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6872
Practice Address - Country:US
Practice Address - Phone:602-840-3705
Practice Address - Fax:602-840-3718
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ27404Medicare ID - Type Unspecified