Individual
MR. STEPHEN W SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
800 SAGUARO TRL, FARMINGTON, NM 87401-9632
(505) 498-6000
Mailing address
1643 NW 136TH AVE, BLDG H SUITE 100 MSC 11607-0004, SUNRISE, FL 33323-2857
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2015-01973
NC
207Q00000X
Family Medicine Physician
Primary
DO2022-0050
NM
Other
Enumeration date
04/08/2014
Last updated
06/06/2022
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