Individual
DR. MICHELE B SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
475 S DOBSON RD, CHANDLER, AZ 85224-5605
(480) 917-1648
Mailing address
7745 E ROLAND CIR, MESA, AZ 85207-1172
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
25735
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
398140-08
—
AZ
01
—
AZ0736120
BC/BS
AZ
Enumeration date
10/19/2006
Last updated
02/08/2013
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