# SHANE MOORE DPM PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255228490
- **Authorized official:** STEVEN SHANE MOORE DPM (OWNER)
- **Authorized official phone:** (480) 241-9848

## Contact information

- **Practice address:** 865 S WATSON RD STE 205, BUCKEYE, AZ 85326-3470
- **Practice address phone:** (623) 974-0522
- **Practice address fax:** (623) 933-5787
- **Mailing address:** 13660 N 94TH DR STE D1, PEORIA, AZ 85381-4275
- **Mailing address phone:** (623) 974-0522
- **Mailing address fax:** (623) 933-5787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 06/20/2025
- **Last updated:** 06/20/2025