Individual
SIMON SHEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8380 S KYRENE RD # D-103, TEMPE, AZ 85284-2120
(480) 269-3208
(480) 674-1295
Mailing address
8380 S KYRENE RD STE D-103, TEMPE, AZ 85284-2120
(480) 269-3208
(480) 674-1295
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R1815
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1815
TRAINING PERMIT
AZ
Enumeration date
07/08/2010
Last updated
04/17/2024
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