Andrew, Shane A

Andrew, Shane A is an individual health care provider with primary practice located at 4424 E Flamingo Ave Suite 110, Nampa ID 83687. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Andrew, Shane A can be contacted via phone (208) 288-4700.

Contact Information

Primary practice address
4424 E Flamingo Ave Suite 110 Nampa ID 83687
Phone: (208) 288-4700
Fax: (208) 288-4720
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X O0443 Idaho
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X OS9764 Florida
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X O-0443 Idaho

Profile Details

NPI number 1356308316
LBN Legal business name Andrew, Shane A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Oct 22nd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356308316 NPPES
Idaho MEDICAID 807749400
Idaho Other P00413752

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