Individual
SHASHIKALA AMENENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6040 E MAIN ST # 516, MESA, AZ 85205-8928
(480) 648-7895
(623) 552-3320
Mailing address
LOCKBOX DEPT 880778, PO BOX 29650, PHOENIX, AZ 85038-9650
(480) 648-7895
(623) 552-3320
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
30598
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2996281
—
OH
05
—
724593
—
AZ
Enumeration date
01/12/2006
Last updated
08/01/2025
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