Individual
SHANE AUGUST JUENEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6685 GUNPARK DR STE 110, BOULDER, CO 80301-3343
(303) 530-3062
(303) 530-5474
Mailing address
5450 WESTERN AVE, SUITE B, BOULDER, CO 80301-2709
(303) 415-7599
(303) 530-5474
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42518
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58634266
—
CO
Enumeration date
01/10/2006
Last updated
11/09/2017
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