Merchant, Shane

Merchant, Shane is an individual health care provider with primary practice located at 410 W 16Th Ave , Tyndall SD 57066-2318. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Merchant, Shane can be contacted via phone (605) 589-2188.

Contact Information

Primary practice address
410 W 16Th Ave Tyndall SD 57066-2318
Phone: (605) 589-2188
Fax: (605) 589-4603
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0887 South Dakota

Profile Details

NPI number 1689001166
LBN Legal business name Merchant, Shane
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2013
Last updated Aug 25th, 2020 - about 6 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 1689001166 NPPES
South Dakota MEDICAID 2007146

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