Individual
SHANE W CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
1310 E DIMOND BLVD, SUITE 1, ANCHORAGE, AK 99515-2031
(907) 344-2400
(907) 344-2404
Mailing address
1310 E DIMOND BLVD, SUITE 1, ANCHORAGE, AK 99515-2031
(907) 344-2400
(907) 344-2404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5887
AK
207QS0010X
Sports Medicine (Family Medicine) Physician
5887
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012003
—
AK
Enumeration date
11/28/2006
Last updated
02/16/2015
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