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Individual

DR. SHANE NICHOLAS WEBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
30 N 1900 E RM 1A07, SALT LAKE CITY, UT 84132-0002
(801) 581-7553
Mailing address
30 N 1900 E RM 1A07, SALT LAKE CITY, UT 84132-0002
(801) 581-7553

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
5101021222
MI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
11085898-1204
UT

Other

Enumeration date
06/09/2014
Last updated
06/12/2019
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