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Individual

DR. SHANE M DALEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1313 E OSBORN RD STE 150, PHOENIX, AZ 85014-5688
(602) 264-4431
(602) 266-3870
Mailing address
77 E THOMAS RD STE 230, PHOENIX, AZ 85012-3100
(602) 557-0007
(602) 557-0002

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
34654
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
345840
AZ
01
P00624719
RAILROAD MEDICARE
AZ
01
P01819220
RAILROAD MEDICARE- ARIZONA UROLOGY SPECIALISTS
AZ
01
Z197365
MEDICARE FOR ARIZONA UROLOGY SPECIALISTS
AZ
Enumeration date
12/30/2005
Last updated
07/21/2022
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