Individual
SANJAY VASUDEVAN SHANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9520 W PALM LN STE 150, PHOENIX, AZ 85037-4454
(602) 584-5444
(602) 584-6202
Mailing address
9520 W PALM LN STE 150, PHOENIX, AZ 85037-4454
(602) 584-5444
(602) 584-6202
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
54987
AZ
207RI0011X
Interventional Cardiology Physician
Primary
54987
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312717
—
AZ
01
—
Z208684
MEDICARE
AZ
Enumeration date
07/17/2007
Last updated
11/12/2021
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