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Individual

DR. TIRUNELLAI RANGANATHAN SHANKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
46 FAIRVIEW AVE STE 223, SKOWHEGAN, ME 04976-1481
(207) 474-7045
(207) 474-5173
Mailing address
PO BOX 468, SKOWHEGAN, ME 04976-0468
(207) 474-7045
(207) 474-5173

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD17663
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000468201
MEDICARE PTAN
05
1780700856
ME
Enumeration date
03/21/2007
Last updated
07/03/2023
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