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NPI 1447637467 · live from the CMS NPI Registry

Shane Michael Ahlstrom, M.D.

Anesthesiology in Medford, OR. National Provider Identifier 1447637467, active.

NPI record

NPI1447637467 Type 1 · individual
StatusActive
Primary specialtyAnesthesiology 207L00000X
Practice location1093 Royal Ct, Medford, OR 97504
Practice phone541-773-7273
Mailing addressPo Box 1705, Medford, OR 97501
EnumeratedApril 28, 2015
Last updatedAugust 1, 2019
Sole proprietorYes

Taxonomies and licenses

TaxonomyCodeLicense
Anesthesiology primary207L00000XMD191421 (OR)

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.