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Individual

DAVID WILLIAM SHOUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
19389 N 59TH AVE, GLENDALE, AZ 85308-6500
(623) 537-6000
(623) 537-6014
Mailing address
19555 N 59TH AVE, GLENDALE, AZ 85308-6813
(623) 537-6000
(623) 537-6014

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
AZ3125
AZ
207Q00000X
Family Medicine Physician
AZ03125
AZ

Other

Enumeration date
09/19/2006
Last updated
02/17/2010
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