Individual
CLAY DANIEL SHORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2940 E BANNER GATEWAY DR STE 200-250, GILBERT, AZ 85234-2168
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5777
AZ
363AS0400X
Surgical Physician Assistant
5777
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055351
—
AZ
05
—
Z211189
—
AZ
Enumeration date
04/13/2010
Last updated
07/29/2022
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