Individual
SHAFEEQ S LADHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
240 W THOMAS RD, SUITE 400, PHOENIX, AZ 85013-4407
(602) 406-6262
(602) 406-6261
Mailing address
240 W THOMAS RD # 400, PHOENIX, AZ 85013-4407
(602) 406-6262
(602) 406-6261
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
Primary
30730
AZ
2084N0400X
Neurology Physician
30730
AZ
2084N0600X
Clinical Neurophysiology Physician
30730
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86080015085259C457
TRIWEST
AZ
05
—
937906
—
AZ
Enumeration date
11/30/2005
Last updated
05/28/2024
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