Shane Anderson
Medical Specialty
Professional ID
- NPI: 1144208661
- PECOS ID: 8426322942
- Enrollment ID: I20170922000341
- Credential(MD, DO, DPM):
- Medical School:
- Medical School Graduation Year: 2002
Hospital Service
- Hospital CCN1: 460041
- Business Name (LBN)1: Davis Hospital And Medical Center
- Hospital CCN2: 460051
- Business Name (LBN)2: Jordan Valley Medical Center
- Hospital CCN3: 460003
- Business Name (LBN)3: Salt Lake Regional Medical Center
- Hospital CCN4: 460009
- Business Name (LBN)4: University Health Careuniv Hospitals And Clinics
Medical Practices
- Organization Name: Mountain Medical Physician Specialists Pc
- Group Practice ID assigned by PECOS: 5294639407
- Number of Group Practice member: 105
Location
- Address1: 5323 Woodrow St
- Address2:
- City: Murray
- State: Utah
- Zip Code: 84107
- Phone Number: (801)713-0600
Location
- Address1: 5444 Green St
- Address2:
- City: Murray
- State: Utah
- Zip Code: 84123
- Phone Number: (801)284-1755
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS):
- Used Electronic health record (EHR):