Mcshan, Michael

Mcshan, Michael is an individual health care provider with primary practice located at 1711 S Henderson Blvd Suite 100, Kilgore TX 75662-3563. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Mcshan, Michael can be contacted via phone (903) 315-3800.

Contact Information

Primary practice address
1711 S Henderson Blvd Suite 100 Kilgore TX 75662-3563
Phone: (903) 315-3800
Fax: (903) 984-5367
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X E4519 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E4519 Texas
Allopathic & Osteopathic Physicians / General Practice 208D00000X E4519 Texas

Profile Details

NPI number 1912082249
LBN Legal business name Mcshan, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Nov 14th, 2014 - about 12 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 1912082249 NPPES
Texas Other 752883733 TAX ID
Texas Other 00BP62 TAX ID
Texas MEDICAID 130926203 TAX ID

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