Individual
DR. SHANE D. LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-3462
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-3462
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7813558-1205
UT
208600000X
Surgery Physician
M9454
TX
208D00000X
General Practice Physician
M9454
TX
Other
Enumeration date
05/14/2008
Last updated
07/21/2022
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