Individual
DR. SHANE NATHANIEL MCCAULEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
01059435A
IN
207Q00000X
Family Medicine Physician
01059435A
IN
207Q00000X
Family Medicine Physician
M-14730
ID
2083A0100X
Aerospace Medicine Physician
01059435A
IN
2083X0100X
Occupational Medicine Physician
Primary
M-14730
ID
Other
Enumeration date
10/20/2005
Last updated
11/05/2019
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