Individual
SHANE L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20401 N 73RD ST STE 160, SCOTTSDALE, AZ 85255-4149
(623) 208-7979
(800) 483-0729
Mailing address
20401 N 73RD ST STE 160, SCOTTSDALE, AZ 85255-4149
(623) 208-7979
(800) 483-0729
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34339
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3Z5706
HEALTHNET
AZ
05
—
583819
—
AZ
Enumeration date
01/17/2006
Last updated
01/01/2023
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