# DR. SHANE A GAILUSHAS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073786521
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | 2013015482 | MO | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | 53757-20 | WI | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | 8995595-1205 | UT | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | MD-43426 | IA | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | MD2015-0203 | NM | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | MED-PHYS-LIC-33185 | MT | — |

## Other

- **Enumeration date:** 04/04/2008
- **Last updated:** 03/09/2021