Individual
DR. KEN SHADMAN OTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9821 N 95TH ST STE 101, SCOTTSDALE, AZ 85258-4589
(480) 365-8035
Mailing address
9821 N 95TH ST STE 101, SCOTTSDALE, AZ 85258-4589
(480) 365-8035
(480) 718-7373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5305
AZ
Other
Enumeration date
07/03/2008
Last updated
11/22/2019
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