Provider Demographics
NPI:1861613267
Name:SHAH, SHEBA (MD)
Entity type:Individual
Prefix:DR
First Name:SHEBA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHEBA
Other - Middle Name:
Other - Last Name:JILANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:604 W WARNER RD
Mailing Address - Street 2:B-3
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2906
Mailing Address - Country:US
Mailing Address - Phone:480-526-5300
Mailing Address - Fax:480-550-8938
Practice Address - Street 1:604 W WARNER RD
Practice Address - Street 2:B-3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2906
Practice Address - Country:US
Practice Address - Phone:480-526-5300
Practice Address - Fax:480-550-8938
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ47193208VP0014X, 208VP0014X
CAA984182081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine