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Individual

SHANE A ANDREW

Active
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Individual

SHANE A ANDREW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
O-0443
ID
207X00000X
Orthopaedic Surgery Physician
O0443
ID
207X00000X
Orthopaedic Surgery Physician
OS9764
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807749400
ID
01
P00413752
RAILROAD MEDICARE
Enumeration date
04/26/2006
Last updated
10/22/2014
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