Individual
GREGORY SHANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 RANCH RD, REEDSPORT, OR 97467-1720
(541) 271-2171
Mailing address
600 RANCH RD, REEDSPORT, OR 97467-1720
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
FS2238853
NY
208600000X
Surgery Physician
Primary
MD153010
OR
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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