Individual
DANIEL J. SHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1209 UNIVERSITY BLVD NE, ALBUQUERQUE, NM 87102-1727
(505) 272-4661
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35064260
OH
207Q00000X
Family Medicine Physician
Primary
MD2016-0070
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0236579
—
OH
Enumeration date
04/02/2007
Last updated
10/23/2024
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