Provider Demographics
NPI:1689152381
Name:MCANDREW, SHANE ANTHONY (CNIM, REPT)
Entity Type:Individual
Prefix:MR
First Name:SHANE
Middle Name:ANTHONY
Last Name:MCANDREW
Suffix:
Gender:M
Credentials:CNIM, REPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8118 CORPORATE WAY STE 212
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9560
Mailing Address - Country:US
Mailing Address - Phone:513-947-8433
Mailing Address - Fax:513-947-9943
Practice Address - Street 1:8118 CORPORATE WAY STE 212
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9560
Practice Address - Country:US
Practice Address - Phone:513-947-8433
Practice Address - Fax:513-974-9943
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic