Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD193284 | OR |
N | 207V00000X | Obstetrician & Gynecologist | MD60912451 | WA |
Y | 207VX0000X | Obstetrician | 62045 | AZ |
NPI | 1083025258 |
---|---|
Provider Name | Shashank Shekhar Srivastava |
First Address | Tampa, FL 33622-5317 |
Second Address | Avondale, AZ 85392-5016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2014 |
Last Update Date | 15/11/2021 |