Individual
GRAY SHANEBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4315 DIPLOMACY DR, ANCHORAGE, AK 99508-5926
(907) 729-1729
Mailing address
4315 DIPLOMACY DR, ANCHORAGE, AK 99508-5926
(907) 729-1729
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1015
AK
Other
Enumeration date
10/19/2009
Last updated
01/12/2015
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