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Individual

STEVEN SHANKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
30 W 89TH STREET, NEW YORK, NY 10024-2037
(216) 255-5700
(216) 255-5701
Mailing address
23625 COMMERCE PARK, SUITE 204, BEACHWOOD, OH 44122
(216) 255-5701
(216) 255-5701

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
150508
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1016624150001
PA
05
12317801
AZ
01
209756897
TRICARE SOUTH
05
2510769
OH
01
341958451020
MEDICAL MUTUAL
OH
01
34195845110024
TRICARE WEST
01
71R36
BCBS
NY
05
807443900
ID
01
P00163856
RXR MEDICARE
NY
Enumeration date
12/12/2005
Last updated
02/17/2015
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