DR. Shane Keith Anderson, D.O.

NPI #1841289659 in Malad City, Idaho

Provider Information

NPI Number: 1841289659
Entity Type: Individual
Name: DR. Shane Keith Anderson, D.O.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Internal Medicine
Credential: D.O.
Enumeration Date: Oct 14, 2005
Last Updated: May 24, 2011

Practice Location

Address: 220 BANNOCK ST
City: Malad City
State: Idaho
ZIP Code: 83252-1256
Phone: (208) 766-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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