Individual
MATTHEW D SHORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5747 N 12TH PL, PHOENIX, AZ 85014-2328
(480) 414-9868
Mailing address
5747 N 12TH PL, PHOENIX, AZ 85014-2328
(480) 414-9868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36166
AZ
Other
Enumeration date
04/03/2007
Last updated
07/27/2021
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