Individual
JOHN S SHAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6716 NW 11TH PLACE, STE 200, GAINESVILLE, FL 32605-4215
(352) 331-9729
(352) 371-3372
Mailing address
6716 NW 11TH PLACE, STE 200, GAINESVILLE, FL 32605-4215
(352) 331-9729
(352) 371-3372
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME39094
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066196100
—
FL
01
—
239216
AVMED
FL
01
—
270855
AVMED
FL
01
—
47440
BCBS FL
FL
01
—
P00241928
RAILROAD MEDICARE
FL
01
—
P00368376
RAILROAD MEDICARE
FL
Enumeration date
05/24/2005
Last updated
11/01/2016
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