Individual
SHANE KEVIN GIANNETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160
(913) 588-1559
(913) 945-6403
Mailing address
35 BURTIS AVE, OYSTER BAY, NY 11771-3020
(862) 368-6355
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021013427
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2019
Last updated
08/05/2021
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