Individual
SHANE KASNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1790 BLAIRS FERRY RD, HIAWATHA, IA 52233-2033
(319) 294-5080
(319) 393-7985
Mailing address
PO BOX 1824, CEDAR RAPIDS, IA 52406-1824
(319) 369-4505
(319) 369-4677
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30805
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1113183
—
IA
Enumeration date
03/21/2006
Last updated
10/25/2007
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