Individual
DR. SHANE A GAILUSHAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MERCY EAR NOSE AND THROAT CLINIC, 901 8TH AVENUE SE, CEDAR RAPIDS, IA 52401
(319) 398-6900
(319) 398-6901
Mailing address
MERCY EAR NOSE AND THROAT CLINIC, 901 8TH AVENUE SE, CEDAR RAPIDS, IA 52401
(319) 398-6900
(319) 398-6901
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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