Provider Demographics
NPI:1194798645
Name:SHEDDEN, TERRANCE ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:TERRANCE
Middle Name:ARTHUR
Last Name:SHEDDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:645 E MISSOURI AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1351
Mailing Address - Country:US
Mailing Address - Phone:602-744-4760
Mailing Address - Fax:602-744-4799
Practice Address - Street 1:1850 N CENTRAL AVE
Practice Address - Street 2:SUITE 1600
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4527
Practice Address - Country:US
Practice Address - Phone:602-744-4760
Practice Address - Fax:602-744-4799
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ30607207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00084324OtherMEDICARE RAILROAD
AZ811853Medicaid
AZ76467Medicare PIN
P00084324OtherMEDICARE RAILROAD