Individual
DR. SHANE A GAILUSHAS
Active
Individual
DR. SHANE A GAILUSHAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
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
Primary
MD-43426
IA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
MD2015-0203
NM
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
MED-PHYS-LIC-33185
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073786521
—
MO
Enumeration date
04/04/2008
Last updated
03/09/2021
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