Individual
DR. SHANE BLAKE ANDERSON
Active
Individual
DR. SHANE BLAKE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
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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