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Individual

DR. SHANE BLAKE ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5334 S WOODROW ST STE 100, MURRAY, UT 84107-5838
(801) 713-0600
Mailing address
5334 S WOODROW ST STE 100, MURRAY, UT 84107-5838

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
328507-1204
UT
207UN0902X
Nuclear Imaging & Therapy Physician
378
NE
2085R0202X
Diagnostic Radiology Physician
Primary
328507-1204
UT
2085R0202X
Diagnostic Radiology Physician
378
NE

Other

Enumeration date
01/04/2006
Last updated
04/27/2026
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