Individual
SHANE L GUFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 567-2180
(317) 567-2191
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01061950A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000479771
ANTHEM
IN
05
—
200841300
—
IN
Enumeration date
06/26/2006
Last updated
12/04/2024
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