Smith, Shane Michael

Smith, Shane Michael is an individual health care provider with primary practice located at 516 W 14Th Ave Ste 100 , Holdrege NE 68949-1215. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Shane Michael can be contacted via phone (308) 995-4431.

Contact Information

Primary practice address
516 W 14Th Ave Ste 100 Holdrege NE 68949-1215
Phone: (308) 995-4431
Fax: (308) 995-3247
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 37886 Iowa
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24107 Nebraska

Profile Details

NPI number 1184705980
LBN Legal business name Smith, Shane Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jun 17th, 2021 - about 5 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 1184705980 NPPES
Iowa MEDICAID 0254656
Iowa Other 0638593
Iowa Other 42047
Iowa Other 168506
Iowa Other 168505

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