Individual
DR. SHAYAN ALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
802 AINSWORTH DR STE A, PRESCOTT, AZ 86301-1623
(928) 771-5548
(928) 771-5549
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A106779
CA
207RG0100X
Gastroenterology Physician
Primary
36010
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344207
—
AZ
Enumeration date
01/23/2006
Last updated
09/29/2025
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