Individual
DR. SHANE ALLEN YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 E RIVER ST, ELYRIA, OH 44035-5902
(440) 323-8458
(440) 323-7900
Mailing address
860 E BROAD ST, SUITE I, ELYRIA, OH 44035-6542
(440) 323-8458
(440) 323-7900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35070189
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2191042
—
OH
Enumeration date
06/20/2006
Last updated
09/14/2010
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