Individual
MICHAEL T SHANDERSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
751 E BAYOU PINES DR, SUITE L, LAKE CHARLES, LA 70601-7196
(337) 436-8700
(337) 433-5942
Mailing address
4705 W QUAIL HOLLOW DR, LAKE CHARLES, LA 70605-5126
(337) 478-8837
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
69234
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1924121
—
LA
Enumeration date
01/20/2006
Last updated
02/26/2008
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