Individual
SHENEN LEAVITT DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9377 E BELL RD, SCOTTSDALE, AZ 85260-1502
(480) 261-9409
(480) 619-4098
Mailing address
9377 E BELL RD, SCOTTSDALE, AZ 85260-1502
(480) 619-4097
(480) 619-4098
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3379
AZ
208M00000X
Hospitalist Physician
Primary
3379
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52849005
—
AZ
05
—
582490
—
AZ
01
—
P00046563
RAIL ROAD MEDICARE ID
AZ
Enumeration date
02/26/2006
Last updated
05/16/2016
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