Lookup NPI Numbers from the NPI Registry
NPI Profile for SHANE UDELHOVEN in SOLDOTNA, AK.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant | |
Student in an Organized Health Care Education/Training Program |
390200000X |
| NPI # | 1124355359 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 11/09/2009 | |
| Last updated | 02/18/2020 - About 6 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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SHANE UDELHOVEN
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SHANE UDELHOVEN, PA-C