Individual
SHAD MISSELDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7600 N 15TH ST STE 290, PHOENIX, AZ 85020-4336
(602) 312-0855
Mailing address
7600 N 15TH ST STE 290, PHOENIX, AZ 85020-4336
(602) 312-0855
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
43059
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
539882
—
AZ
Enumeration date
08/14/2007
Last updated
04/21/2023
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