NPI 1457466823 · live from the CMS NPI Registry
Theresa Joanne Shanley, M.D.
Radiology, Diagnostic Radiology in Fairbanks, AK. National Provider Identifier 1457466823, active.
NPI record
| NPI | 1457466823 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 1650 Cowles St, Fairbanks, AK 99701 |
| Practice phone | 907-458-5660 |
| Mailing address | Po Box 70378, Fairbanks, AK 99707 |
| Enumerated | August 19, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology primary | 2085R0202X | 5533 (AK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.