Individual
SUSAN SHOTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT (R)
Contact information
Practice address
861 N HIGLEY RD STE B101, GILBERT, AZ 85234-9602
(480) 813-9600
(480) 813-9601
Mailing address
555 S 107TH ST, MESA, AZ 85208-5703
(484) 272-4239
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
CRT18236
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CRT18236
STATE F AZ LICENSE
AZ
Enumeration date
08/09/2020
Last updated
08/09/2020
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